Maryland General Hospital Agrees To Pay $750,000 To Resolve False Claims Act Allegations In Connection With Overbilling For Cardiac Testing
Baltimore, Maryland - Maryland General Hospital (“MGH”), an acute care hospital in Baltimore, Maryland that is part of the University of Maryland Medical Systems Corporation, agreed to pay $750,000 to settle allegations under the False Claims Act. The government alleged that MGH overbilled in connection with cardiac testing and failed to repay the overpayments after senior financial managers learned of them.
The settlement was announced by United States Attorney for the District of Maryland Rod J. Rosenstein and Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services.
The allegations resolved in the settlement include overbilling of cardiac perfusion studies performed in MGH from March 24, 2003 through December 23, 2009. The allegations resolved also relate to MGH’s failure to repay overbilled amounts after senior financial managers learned of the overpayments. Evidence established that senior financial managers at MGH were made aware of the overpayments in February and August 2007. Federal law requires that recipients of overpayments by the Medicare system identify them and repay them. Despite its awareness of the problem MGH failed to do so until this litigation.
The allegations settled today arose from a lawsuit filed by Kenneth Creeger against MGH under the qui tam, or whistleblower, provisions of the False Claims Act. United States ex rel. Kenneth Creeger v. Maryland General Hospital, No. 1:10-cv-0281 (D. Md.). The Act allows private citizens with knowledge of fraud to bring civil actions on behalf of the United States and share in any recovery. As part of today’s resolution, Mr. Creeger will receive $119,728 from the settlement.
This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover more than $10.7 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $14.5 billion.
The settlement was a result of an investigation by the U.S. Attorney’s Office for the District of Maryland and the Justice Department’s Civil Division, the Inspector General of Department of Health and Human Services. The case was handled by Assistant U.S. Attorney Allen Loucks.