South County Hospital pays federal government $750,000 for overbilling

WAKEFIELD, R.I. — South County Hospital has paid the federal government $750,000 for excessive Medicare and Medicaid reimbursement claims the hospital submitted for outpatient laboratory tests, according to the office of U.S. Attorney Margaret E. Curran.

According to the settlement agreement reached by the hospital’s lawyers and the U.S. Attorney’s office, the hospital received Medicare and Medicaid funds it wasn’t entitled to by overstating the number of tests performed for Medicare and Medicaid patients. According to the agreement, the hospital’s computer-generated claims billed for between two and 19 times more tests than had actually been performed. The overbilling occurred between 1989 and 1996, according to the settlement.

The U.S. Department of Health and Human Services Office of Inspector General, the FBI and the Rhode Island Attorney General’s Medicaid Fraud Control Unit had conducted a review of South County Hospital’s Medicare billing procedures. The Unites States contended it had civil claims against the hospital under the False Claims Act, and the State of Rhode Island contended it had claims against the hospital under the state’s Medical Assistance Fraud law.

The hospital admitted no wrongdoing in the settlement, but agreed to make the $750,000 payment to resolve the government’s allegations, Curran’s office said.

- Advertisement -