Abington Memorial Hospital to Pay $491,672 to Settle False Claims Act Liability for Improper Medicare Reimbursement Submissions

Acting United States Attorney Louis D. Lappen announced that Abington Memorial Hospital, which does business as Abington Hospital – Jefferson Health (AMH), has agreed to pay the United States $491,672, to resolve allegations that an AMH employee forged physician signatures on forms submitted to the Medicare program for home care services. These forms required physicians’ genuine signatures for such claims to be reimbursed by Medicare.

In June 2016, AMH disclosed to the Government its discovery that during a period beginning in May 2014, AMH’s affiliated home care agency, Jefferson Abington Health Home Care and Hospice, had submitted claim forms on which an AMH employee had improperly cut-and-pasted the required physician signatures. Accordingly, there was no legitimate physician authorization on these forms.

In addition to reporting the conduct to the Government, AMH promptly reversed any claims to Medicare that were within one year of billing and repaid the money received in reimbursement for those claims. AMH has also taken corrective measures to prevent such conduct from recurring. These measures include terminating the employee responsible and installing a computer program that requires physicians’ electronic signatures, eliminating the need for AMH to obtain physical signatures.

“Medicare beneficiaries are entitled to receive care that is determined by their clinical needs, and if health providers wish to be reimbursed with taxpayer funds, they must follow the rules and ensure that the services they provided were properly authorized and documented,” said Acting U.S. Attorney Lappen. “We commend Abington Memorial Hospital for coming forward to disclose its problems and for working to improve its practices to ensure compliance by all personnel.”

The case was handled by Assistant United States Attorneys Paul W. Kaufman and Mark J. Sherer