Navigation Links
Pennsylvania Hospital Pays $1.9 Million to Settle Medicare Fraud Case Brought by Whistleblower
Date:11/24/2008

Inflated Medicare reimbursement claims alleged in "qui tam" lawsuit

ERIE, Pa., Nov. 24 /PRNewswire/ -- St. Vincent Health System Inc., based in Erie, Pennsylvania, has agreed to pay $1.9 million to the federal government to settle a whistleblower lawsuit that alleged the hospital submitted reimbursement claims to Medicare that greatly exceeded its actual costs.

The settlement by St. Vincent -- filed in district court in Newark, New Jersey, today - is the latest of several settlements by hospitals named in a "qui tam" (whistleblower) lawsuit brought in 2005 by Anthony Kite, an independent hospital consultant in New Jersey.

Kite alleged in his lawsuit that St. Vincent inflated its reimbursement claims to Medicare from 2001 to 2003 to receive supplemental, or "outlier," payments. Similar allegations were made against the other hospitals. The Medicare program makes outlier payments to hospitals when the actual costs for treating a particular patient greatly exceed a predetermined reimbursement amount for that type of treatment.

"The outlier program has been vulnerable to fraud by healthcare providers," said Larry P. Zoglin, a San Francisco attorney with Phillips & Cohen, which is representing the whistleblower in the qui tam case. "In numerous instances, whistleblowers have exposed this drain on Medicare."

Most qui tam lawsuits succeed only if the government joins the case. But for the second time in Kite's lawsuit, Phillips & Cohen secured a settlement for the federal government without government intervention. Last month, St. Joseph Healthcare System Inc. paid $1.75 million to the federal government to settle its case.

Cooper University Hospital in Camden, New Jersey paid $3.85 million to settle a case brought by Kite. In addition, Kite was one of several whistleblowers who brought successful qui tam lawsuits against Warren Hospital in Phillipsburg, New Jersey (which settled for $7.5 million); Bayonne Medical Center in Bayonne, New Jersey ($2.5 million); Cathedral Healthcare System, in Newark, New Jersey ($5.3 million); and Raritan Bay Medical Center in Perth Amboy, New Jersey ($7.5 million).

Phillips & Cohen is the largest and most successful law firm that specializes exclusively in representing whistleblowers in qui tam lawsuits and tax fraud matters. Cases brought by the firm on behalf of whistleblowers have returned nearly $3 billion to the federal government.

For more information about Phillips & Cohen, qui tam lawsuits and tax fraud whistleblowers, see www.phillipsandcohen.com.

Case citation: U.S. ex rel. Kite v. Besler Consulting, et al, Case No. 05 :CV3066 (D.N.J.)


'/>"/>
SOURCE Phillips & Cohen LLP
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. Pennsylvania Governor Rendell Remembers, Celebrates the Life of Lt. Governor Catherine Baker Knoll During Capitol Tribute
2. Pennsylvania Health Department Reminds Parents to Immunize Their Children Against Pertussis
3. Pennsylvania Insurance Department Approves Launch of Senior Health Care Oversight Trust
4. Conseco Completes Transfer of Senior Health Insurance Company of Pennsylvania to Independent Trust
5. Independence Blue Cross Celebrates 70 Years Of Service In Southeastern Pennsylvania
6. Highmark Healthy High 5 School Challenge Grant Program Enables Pennsylvania Schools to Implement or Enhance Healthy Lifestyle Programs for Students
7. Pennsylvania Patient Safety Authority Hires Director of Educational Programs
8. NAMI Pennsylvania Announces Program for Annual Statewide Conference
9. Pilot Program Successfully Addresses Mental Health Issues in Pennsylvanias Children
10. Level III Trauma Center Accreditation Status for Pennsylvania
11. Mobile Massage Team Announces Expansion of On-Site Seated Massage Services Throughout Eastern Pennsylvania and the Greater Philadelphia Region
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/27/2017)... ... 2017 , ... The Incentive Research Foundation is pleased to ... a groundbreaking analysis of how behavioral economics can be applied to the incentive, ... programs, the report highlights proven behavioral economics approaches and the powerful role emotions ...
(Date:4/27/2017)... ... April 27, 2017 , ... Last night, ... CAREGiverSM of the Year for her extraordinary compassion and lifelong dedication to serve ... American professional caregivers for the prestigious award each year – identifying a CAREGiver ...
(Date:4/27/2017)... Atlanta, GA (PRWEB) , ... April 27, 2017 , ... ... is a tragic spike in water-related accidents and drownings during the summer. While most ... reality is that these situations occur every day. Very few people are taking the ...
(Date:4/26/2017)... ... April 26, 2017 , ... Journal of Oral Implantology ... severe consequences to overall dental health, including complications with speech, eating, and overcompensation of ... implants to replace lost teeth. As the number of tooth replacements increase, it is ...
(Date:4/26/2017)... ... April 26, 2017 , ... Elisabete Miranda, president and ... by Enterprising Women magazine as one of its 2017 Enterprising Women of the ... Winners have demonstrated that they have fast-growth businesses, mentor or actively support other ...
Breaking Medicine News(10 mins):
(Date:4/20/2017)... MINNEAPOLIS , April 20, 2017  Cogentix ... company focused on providing the Urology, Uro/Gyn and ... reported that Ash Keswani has joined the Company ... In this newly created position, Mr. Keswani will ... and CEO. "Our organization is delighted ...
(Date:4/20/2017)... 2017 Research and Markets has ... and Market Prospects: Addressing Production Complexities Through Risk Management ... ... Biosimilar Pipeline and Market Prospects: Overcoming Production Complexities Through ... assessment of the current trends in the global biosimilars ...
(Date:4/20/2017)... 2017  CVS Pharmacy, the retail division of ... store design to enhance the retail customer experience ... products and expanded beauty selections paired with informational ... new offerings. Together with its innovative digital programs, ... customer experience at CVS Pharmacy.  ...
Breaking Medicine Technology: