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South Carolina hospital pays settlement for violating exclusion list

Compliance Monitor, January 21, 2004

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Lexington Medical Center, a 292-bed hospital in West Columbia, SC, agreed last month to pay $99,400 to settle two incidents of submitting claims from excluded providers, according to a January 12 story in Modern Healthcare.

The hospital submitted claims to Medicare for services rendered by employed individuals who had been excluded by the Office of the Inspector General (OIG). The hospital conducted background checks on at least one of the providers, but the results did not surface.

One excluded provider had allegedly illegally submitted $17,000 in claims, while the other allegedly failed to repay student medical loans. The settlement included the amount of claims from both providers as well as penalties.

"A background check was done, but a clerical error was made," said Lexington President and Chief Executive Officer Michael Biediger in the article. "On routine checks later we picked up the exclusions and self-reported to the Inspector General. Since then we've worked with the Inspector General to try to clear things up and move forward."

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