Charles Cole Memorial Hospital Agrees To Settle Over Billing Allegations

HARRISBURG - The United States Attorney’s Office for the Middle District of Pennsylvania announced today that on May 4, 2018, Charles Cole Memorial Hospital, a Pennsylvania nonprofit corporation in Coudersport, Pennsylvania, agreed to pay the United States $373,547.54 to settle allegations from two self-disclosures by Charles Cole to the Office of Inspector General for the United States Department of Health and Human Services (OIG) through the OIG’s Provider Self-Disclosure Protocol.

According to United States Attorney David J. Freed, the first self-disclosure and the investigation that followed, from August 1, 2007, through December 2013, alleged that Charles Cole failed to bill under a particular modifier to reduce the Medicare reimbursement amount for services provided by physician assistants and nurse practitioners in its pain management, orthopedics, gastroenterology, and medical oncology physician office practices.  According to the second self-disclosure and the investigation that followed, Charles Cole allegedly failed to perform required face-to-face encounters with some of its Medicare hospice patients prior to the third benefit period recertification and every subsequent benefit period re-certification from January 1, 2001 through February 1, 2014. Charles Cole has since taken corrective action and voluntarily disclosed these matters.  This settlement resolves the matter without the filing of litigation.

This case was investigated by the Office of Inspector General for the United States Department of Health and Human Services. This matter was handled by Assistant United States Attorney Melissa Swauger for the United States Attorney’s Office.

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