FOR IMMEDIATE RELEASE
FRIDAY, JULY 10, 1998
(202) 616 2765
TDD (202) 514 1888
ATLANTA HOSPITAL PAYS $4.3 MILLION
TO SETTLE FALSE CLAIMS ALLEGATIONS
WASHINGTON, D.C. Grady Memorial Hospital, of Atlanta, has agreed to settle allegations that the hospital submitted false prescription claims for Medicaid patients between 1984 and 1994, the Department of Justice announced today.
Assistant Attorney General Frank Hunger and United States Attorney for the Northern District of Georgia Richard H. Deane, Jr., said the settlement stems from a False Claims Act suit filed against Fulton DeKalb Hospital Authority d/b/a Grady Memorial Hospital. Today's settlement does not constitute evidence of or an admission of liability by Grady Memorial Hospital.
The case was filed in May 1996 by Craig Heyrman, who was a Pharmacy Reimbursement Manager at Grady Memorial Hospital. Heyrman alleged that Grady submitted false prescription claims to the Georgia Medicaid program by charging two dispensing fees for all Medicaid prescriptions from 1984 through December 1994. According to the complaint, Grady's prescription billing procedures violated Medicaid policies by charging Grady's "usual and customary" dispensing fee and the statutory Medicaid dispensing fee, which was in excess of the amounts that could be properly claimed.
Under the qui tam provisions of the False Claims Act, a private party may bring suit on behalf of the United States to recover damages resulting from the knowing submission of false claims to the government. The party, referred to as the relator, is entitled to receive a share of the proceeds of the recovery in these cases.
Grady Hospital has paid $4,326,972 to the United States, of which Heyrman will receive $778,855 as his share under the statute.
The United States intervened in the case following an investigation by the Department of Health and Human Services, Office of Inspector General, the Federal Bureau of Investigation, and the Georgia Department of Medical Assistance.