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Justice News

Department of Justice
U.S. Attorney’s Office
Northern District of New York

Thursday, October 16, 2014

Our Lady Of Lourdes Memorial Hospital Has Paid More Than $3.37 Million To Resolve Self-disclosed Billing Improprieties

ALBANY, NEW YORK – Our Lady of Lourdes Memorial Hospital, Inc. (Lourdes), a 242-bed hospital located in Binghamton, New York, has paid $3,373,898.28 to resolve False Claims Act liability stemming from Medicare billing improprieties that the hospital selfdisclosed to the federal government, announced United States Attorney Richard S. Hartunian.

During the course of an internal review, Lourdes determined that from February 2008 through September 2013, it had improperly billed and was thus overpaid by the Medicare program for hyperbaric oxygen therapy services rendered by a third party in a facility that failed to satisfy the requirements for “provider-based status” set forth in federal regulations. The hospital promptly took corrective steps to remedy the problem and then brought its findings to the government’s attention. Due in large part to Lourdes’s decision to self-disclose these issues and its cooperation throughout the government’s investigation, the hospital was required to pay far less than the treble damages and penalties that the United States is authorized to seek under the False Claims Act. Furthermore, the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) decided that Lourdes would not have to enter into a corporate integrity agreement or adopt other compliance measures.

United States Attorney Hartunian said: “Today’s settlement is an excellent example of how voluntary self-disclosure benefits both the integrity of health care programs and providers who discover and report evidence of improper billing in their organization. Lourdes should be commended for the manner in which it handled the disclosure.”

“In coordination with our law enforcement partners, our agency’s investigators and attorneys will continue to work with health care providers who use the self-disclosure protocol to resolve billing improprieties,” said Special Agent in Charge Thomas O’Donnell of HHS-OIG’s New York region.

The United States encourages all health care providers to self-disclose any known violations that have resulted in the submission of improper claims to federal health care programs. This investigation and settlement were the result of a coordinated effort between the United States Attorney’s Office for the Northern District of New York and HHS-OIG. Locally, the United States was represented by Assistant United States Attorney Adam J. Katz.

Updated January 29, 2015