Robert F. Kennedy Medical Center Settles Medicare Fraud Lawsuit

The Robert F. Kennedy Medical Center in Hawthorne has agreed to pay $2 million to settle a federal lawsuit accusing the hospital of Medicare fraud, the U.S. attorney's office announced Tuesday, the Los Angeles Times reports (Bonilla, Los Angeles Times, 2/6). The lawsuit, filed in 1996 on behalf of the government by Doylestown, Pa.-based Health Outcomes Technologies under the U.S. False Claims Act, accused the hospital of "upcoding," the practice of billing Medicare for a more serious, and more expensive, condition than is actually treated (AP/Sacramento Bee, 2/4). According to Assistant U.S. Attorney Donna Maizel, the hospital billed Medicare for treating severe respiratory infections when it was actually treating pneumonia; the difference in reimbursement costs is approximately $2,500 per case, the Times reports (Los Angeles Times, 2/6). In a statement, RFK Medical Center, which did not admit any wrongdoing, said it "cooperated fully" with the investigation, which began in 1997 and focused on bills submitted from 1994 to 1998, when the hospital was under different management. "RFKMC takes this issue very seriously and regrets that incorrect bills were submitted," hospital president and CEO Joan Bero said. Because of the settlement, the U.S. attorney's office has asked for the case to be dismissed. Health Outcomes Technologies received a settlement of $280,000 (Nix, Torrance Daily Breeze, 2/5).