HCA Finalizes Settlements With Justice Department, CMS
HCA, the nation's largest for-profit hospital chain, yesterday signed agreements with the Justice Department to settle allegations that the company made false claims to Medicare and other federal health insurance programs, the Washington Times reports (Seper, Washington Times, 6/27). Under the agreements, which were first announced last December and require court approval, HCA will pay the Justice Department $631 million and accrued interest (Wall Street Journal, 6/27). The settlement resolves the issues that remain in the Justice Department investigation of HCA -- the largest fraud investigation conducted by the department (Washington Times, 6/27). HCA yesterday also signed an agreement with CMS to settle Medicare cost-report, home-office cost-statement and appeal issues for cost-report periods that ended before Aug. 1, 2001. The agreement, announced in March 2002, requires HCA to pay CMS $250 million within five business days. In addition, HCA finalized an agreement with negotiators that represent states over claims that may be similar to those made by the Justice Department. Under the agreement, announced last December, HCA will pay $17.7 million to state Medicaid programs to resolve the claims (Wall Street Journal, 6/27).
The investigations into HCA began as a result of eight whistleblower lawsuits filed against the company since 1993. The lawsuits allege that HCA overstated expense statements, charged for services ineligible for reimbursements and paid physicians to encourage referrals to HCA facilities (California Healthline, 5/8). HCA took a fourth-quarter after-tax charge of $468 million related to the lawsuits (Bloomberg/Denver Post, 6/27). "Health care providers and professionals hold a public trust, and when that trust is violated by fraud and abuse of program funds, and by the payment of kickbacks to the physicians on whom patients and the programs rely for uncompromised medical judgment, health care for all Americans suffers," Assistant U.S. Attorney General Robert McCallum said (Washington Times, 6/27).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.