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Hospital Accused of Medicare Fraud Will Repay $750K

Settlement announced one day after charges filed.

Published: July 16, 2014

An Upstate New York hospital has agreed to pay the federal government $750,000 to settle accusations that it double-billed Medicare about 1,900 times over a 5-year period ending in 2010, according to news reports.

One day after the government filed a lawsuit against Carthage Area Hospital, both parties said the matter had been settled. The suit, which was filed last week, accused the hospital of repeatedly submitting codes that in effect claimed single services or procedures were performed both in the hospital's ambulatory surgery center and in its operating room.

The hospital says it conducted a self-audit once the "errors" were brought to its attention and that it reported its findings to HHS and the U.S. Attorney. The settlement, it says, was reached before the lawsuit was filed, but "the filing was deemed necessary by the U.S. Attorney to implement the settlement agreement."

The lawsuit sought triple damages, but a statement from the U.S. Attorney in Syracuse says the government settled for the amount overcharged, because "unique circumstances" were involved. A hospital spokesperson told the Watertown (N.Y.) Daily Times that the double-billings took place under the hospital's previous administration and that the hospital had been working with HHS for the last few years to correct the situation.

The settlement calls for the hospital to pay back the $750,000 over a 5-year period, so as not to "negatively impact its operations," says the hospital.

Jim Burger

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