Corporate Compliance

Georgia hospital pays $13.9 million to resolve Medicaid False Claims Act charges

Compliance Monitor, December 29, 2010

John D. Archbold Memorial Hospital Inc. paid the United States $13.9 million to settle allegations that the hospital submitted false claims to the Georgia Medicaid program, according to a Department of Justice (DOJ) press release.

The settlement resolves allegations that the hospital falsely represented itself as a public hospital in order to increase Medicaid reimbursement. Between 2002 and 2008 Archbold Memorial received millions of dollars in Medicaid upper payment limit and disproportionate share hospital funds to which it was not entitled, according to the DOJ.

Wesley Simms, MD, filed the case under the qui tam provision of the False Claims Act and will receive $695,000 from the settlement amount.

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