Catholic Healthcare West Agrees to $8.5M Settlement with Federal Government Over Improper Medicare Billing
Catholic Healthcare West, the state's largest not-for-profit hospital chain, announced Tuesday that the company will pay the federal government $8.5 million to settle allegations in a whistle-blower lawsuit that a number of CHW hospitals submitted false claims to Medicare and other federal programs, the San Francisco Chronicle reports. In 1999, Joseph Kimball, an analyst who prepared cost reports for CHW affiliate Mercy Healthcare Sacramento, filed a lawsuit that accused the hospital system of "making false statements in federal reimbursement claims" (San Francisco Chronicle, 6/7). The Department of Justice joined the lawsuit against Mercy Healthcare in May 2000 and later expanded the suit to include 13 other CHW hospitals (California Healthline, 2/21/01). As part of the settlement, CHW "did not admit any wrongdoing" in the case and attributed the billing problems to "complex and confusing federal regulations." CHW Vice President William Hunt said, "We believe we interpreted those regulations fairly and reasonably, consistent with the interpretation followed by the courts and Medicare itself, and any errors were inadvertent" (San Francisco Chronicle, 6/7). Last year, CHW paid $10.75 million to settle a 1994 civil suit that alleged four CHW hospitals improperly billed Medicare for experimental cardiac devices (California Healthline, 8/10/01).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.