Thirteen hospitals in California, Nevada and Arizona are alleged to have overbilled Medicare and TRICARE.
According to a statement from the U.S. Department of Justice, Dignity Health has agreed to pay the U.S. $37 million to settle allegations that more than a dozen of its hospitals in California, Nevada and Arizona overbilled Medicare and TRICARE by admitting patients who could have been treated on a less costly, outpatient basis.
“Charging the government for higher cost inpatient services that patients do not need wastes the country’s vital health care dollars,” posited Acting Assistant Attorney General Joyce R. Branda for the Justice Department’s Civil Division in a statement. “This department will continue its work to stop abuses of the nation’s health care resources and to ensure patients receive the most appropriate care.”
According to the Department of justice, the admission of multiple patients who do not require inpatient care can negatively impact federal health care programs because hospitals typically receive significantly greater payments from Medicare and TRICARE programs for inpatient admissions.
In addition to paying $37 million, the Department of justice says that Dignity has also entered into a corporate integrity agreement with the U.S. Department of Health and Human Services requiring the healthcare company to make significant compliance efforts over the next five years.
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