HCA to Pay $95M in Medicare Fraud Case
The Justice Department is expected to announce today that Nashville, Tenn.-based HCA-The Healthcare Co. has pleaded guilty and agreed to pay $95.3 million to settle criminal charges it defrauded Medicare and other federal insurance programs, the Nashville Tennessean reports. The settlement marks the end of the government's five-year case against HCA, the nation's largest hospital chain, for "systematic[ally]" conspiring to defraud the government. According to the charges outlined in a one-page summary of the settlement obtained by Bloomberg News, HCA, formerly known as Columbia/HCA Healthcare, engaged in Medicare fraud by "making false statements, paying kickbacks to doctors and submitting false bills" (Russell, Nashville Tennessean, 12/14). The Justice probe of HCA, which was disclosed in 1997 when the FBI raided several HCA hospitals, "left the entire health care industry shaken," the Wall Street Journal reports (Wall Street Journal, 12/14). In May, HCA agreed to a $745 million civil settlement over charges it "overbilled for laboratory and home health care services and exaggerated the severity of pneumonia cases to maximize payments from the government (Nashville Tennessean, 12/14). One condition of the settlement was that the Justice Department would close its criminal investigation by Dec. 31 (Wall Street Journal, 12/14).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.