MEDICARE FRAUD: UC HOSPITALS COME UNDER FIRE
In a case with "broad implications," the five medicalThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
centers in the University of California (UC) system have been
sued for Medicare fraud by two former employees, and could face
"severe financial penalties," SAN DIEGO UNION-TRIBUNE reports.
Sources said that the medical centers are accused of defrauding
the government by billing for care provided by faculty physicians
when the services were actually provided by residents, interns or
fellows. The University of Pennsylvania paid $30 million last
year to settle similar accusations.
WHISTLE WHILE YOU WORK: Federal authorities are
investigating the lawsuit, which was filed under the federal
whistle-blower's law. The law permits employees who "uncover
financial wrongdoing to share with the government in any
recovered proceeds." The suit must remain confidential while the
government decides whether the claim has merit and whether it
will take over the suit. If the government chooses not to pursue
the suit, the whistle-blowers could pursue it on their own.
University officials denied any knowledge of false billing and
said that they were cooperating with the investigation.
IMPACT: The UNION-TRIBUNE reports that any financial
penalties resulting from the suit "could have a major
administrative and financial impact on the medical centers,
several of which are reeling from serious financial problems."
The University of California has medical centers in Davis,
Irvine, Los Angeles, San Diego and San Francisco (Dalton, 7/13).