Beth Israel to pay $5.3M settlement to resolve Medicare fraud allegations

Beth Israel Deaconess Medical Center has agreed to pay $5.3 million to the federal government to resolve allegations that it violated the False Claims Act by billing Medicare for inpatient stays that should have been treated as outpatient or observation cases.

But Beth Israel says that what the U.S. Attorney?s office calls fraud, the hospital calls quality care.

A statement from Beth Israel reads in part, ?Indeed, during the inquiry, BIDMC vigorously defended claims for an inpatient level of service delivered to patients whom physicians had concluded should be admitted to the hospital because of their condition Under the settlement, BIDMC admits no liability whatsoever.?

The improper claims, for one-day stay inpatient admissions for patients with congestive heart failure, chest pain, and certain digestive and nutritional disorders were submitted from June 1, 2004, through March 31, 2008, according to U.S. Attorney Carmen Ortiz? office. These claims should have been billed as observation services, federal investigators said. In addition, the settlement resolves allegations that BIDMC submitted claims to Medicare for less-than-one day stays that should have been billed as outpatient or observation services. Medicare reimburses hospitals at significantly higher amounts for inpatient admissions versus outpatient or observation services.

?When hospitals unnecessarily admit Medicare patients for short inpatient stays when the appropriate treatment would be outpatient or observation care, they improperly boost hospital profits at significant expense to taxpayers and patients,? Susan J. Waddell, Special Agent in Charge of the Department of Health & Human Services, Office of Inspector General, said in a statement. ?We are committed to uprooting such schemes to eliminate waste in federal health care programs.?

Health Care/Life Sciences

Source: http://feedproxy.google.com/~r/bizj_boston/~3/Jp5YJZrpY_Y/beth-israel-to-pay-53-million.html

honda classic news channel 5 nashville weather jason varitek andrew breitbart dead sheriff joe arpaio limbaugh