Corporate Compliance

St. Joseph's Hospital of Atlanta to pay $26M to settle FCA allegations

Compliance Monitor, January 9, 2008

St. Joseph's Hospital of Atlanta and St. Joseph's Health System will pay the federal government $26 million to settle allegations the hospital violated the False Claims Act by overcharging Medicare between 2000 and 2005, according to a Department of Justice (DOJ) press release.

The settlement resolves allegations that St. Joseph's billed Medicare for short inpatient admissions, usually of one day or less, when the services should have been billed on an outpatient "observation" basis or as an emergency room visit.

The hospital also admitted patients who did not meet the criteria for covered admission, for three days, so patients would be eligible for Medicare payments for subsequent skilled nursing facility services, according to the DOJ.

Tami Ramsey, a registered nurse and former hospital employee, filed a whistleblower lawsuit against St. Joseph's and will receive $4.94 million of the settlement.

In addition to the monetary settlement, St. Joseph's entered into a corporate integrity agreement.

Click here to read the DOJ's press release.

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