Health Care Providers Agree To Pay Over $900,000 To Settle False Claims Allegations

November 30th, 2012 by Qui Tam

The United States Department of Justice has announced that Baylor University Medical Center, Baylor Health Care System and HealthTexas Provider Network (collectively referred to as “Baylor”) have agreed to pay $907,355 to revolve charges that they submitted false claims to Medicare, the Civilian Health and Medical Program of the Uniformed Services and the Federal Employees Health Benefit Program.  The government claimed that between 2006 and May 2010, Baylor double billed Medicare for several procedures relating to radiation treatment plans; billed for certain high reimbursement radiation oncology services when a different, less expensive service should have been used; billed for procedures without supporting documentation in the medical record and improperly billed for radiation treatment delivery without corroboration of physician supervision.  Principal Deputy Attorney General for the Justice Department’s Civil Division, Stuart F. Delery, stated, “[p]hysicians who participate in Medicare must bill for their services accurately and honestly” and that “[t]he Department of Justice is committed to ensuring that federal health care funds are spent appropriately.”  The settlement only represented a resolution of the claims which had been brought against Baylor and there was no determination of liability. 

This case was a part of the government’s emphasis on combating health care fraud and involved the Health Care Fraud Prevention and Enforcement Action Team which is a partnership between the United States Department of Justice and the United States Department of Health and Human Services.  The Team focuses on reducing and preventing Medicare and Medicaid financial fraud. 

For more information, please see:
http://www.justice.gov/opa/pr/2012/November/12-civ-1413.html

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