News: Dignity Health Resolves False Claims' Suit with $37 Million Settlement
CDI Strategies, November 6, 2014
Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!
Inpatient admissions for patients undergoing cardiovascular procedures such as implants of stents and pacemakers and elective kyphoplasty procedures appears to be the culprit behind a $37 million dollar False Claims Act settlement between the government and Dignity Health, according to a recent report from the OIG.
Dignity, formerly known as Catholic Healthcare West, is based in San Francisco and is one of the five largest hospital systems in the nation with 39 hospitals in California, Nevada, and Arizona.
The suit examined records related to elective cardiovascular scheduled surgeries from 2006 through 2010 at 13 Dignity facilities, with the government alleging such surgeries should have been billed as outpatient surgeries. Additional the OIG reviewed records from 2000 to 2008, finding four hospitals inappropriately billing for elective kyphoplasty procedures treatments.
“Lastly, the government alleged that from 2006 through 2010, 13 hospitals admitted patients for certain common medical diagnoses where admission as an inpatient was medically unnecessary and appropriate care could have been provided in a less costly outpatient or observation setting,” the OIG report states.
“Charging the government for higher cost inpatient services that patients do not need wastes the country’s vital health care dollars,” said Acting Assistant Attorney General Joyce R. Branda for the Justice Department’s Civil Division. “This department will continue its work to stop abuses of the nation’s health care resources and to ensure patients receive the most appropriate care.”
Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!
Related Products
-
Briefings on APCs
Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...
-
HIM Briefings
Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...
-
Briefings on Coding Compliance Strategies
Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...
-
Briefings on HIPAA
How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...
-
APCs Insider
This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Practice the six rights of medication administration
- What to include on the incident report
- Note similarities and differences between HCPCS, CPT® codes
- Code diagnoses and outpatient treatment for PTSD
- Q&A: Primary, principal, and secondary diagnoses
- Complications from immobility by body system
- Differentiate between types of wound debridement
- OB services: Coding inside and outside of the package
- Know guidelines and subtle differences in code descriptions for laceration repairs
- E-mailed
-
- Q/A: Reporting hydration with phlebotomy
- Q&A: Changes to Joint Commission maintenance standards and AEMs
- Pneumonia with a negative chest x-ray: Clinical diagnoses, physician documentation, and coding guidelines
- Nurse managers' role in evidence-based practice
- Learn how one facility reduced bed turnaround time by 76%
- Is a pre-application form really necessary?
- History and development of shared governance
- Fracture coding in ICD-10-CM requires greater specificity
- Don't forget the three checks in medication administration
- Dig into the details of wound care documentation
- Searched
