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:6/25/2016)... ... 25, 2016 , ... First Choice Emergency Room , the largest network ... the Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased ... location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. Calvin Johnson ... Recently, he has implemented orthobiologic procedures as a method for treating his patients. ... the first doctors to perform the treatment. Orthobiologics are substances that orthopaedic surgeons ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether ... latter, setting the bar too high can result in disappointment, perhaps even self-loathing. However, ... their goal. , Research from PsychTests.com reveals that behind the tendency ...
(Date:6/24/2016)... ... 24, 2016 , ... Those who have experienced traumatic events may suffer from ... avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid this ... coping following a traumatic event. , Trauma sufferers tend to feel a range of ...
(Date:6/24/2016)... ... ... Marcy was in a crisis. Her son James, eight, was out of control. Prone to ... , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there ... my other children and say he was going to kill them. If we were ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016  MedSource announced today that ... e-clinical software solution of choice.  This latest decision ... value to their clients by offering a state-of-the-art ... relationship establishes nowEDC as the EDC platform of ... full-service clients.  "nowEDC has long been a preferred ...
(Date:6/23/2016)... -- Research and Markets has announced the ... (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic Chemical), Functionality (Filler, ... Global Forecast to 2021" report to their offering. ... pharmaceutical excipients market is projected to reach USD 8.1 ... the forecast period 2016 to 2021. ...
(Date:6/23/2016)... , June 23, 2016 Research and ... Devices Medical Market Analysis 2016 - Forecast to 2022" ... The report contains up to date financial data derived ... Assessment of major trends with potential impact on the market ... of market segmentation which comprises of sub markets, regional and ...
Breaking Medicine Technology: