Wednesday, December 14, 2005

Construction firm to pay $3 million to resolve False Claims Act suit

Williams Brothers Construction Company has agreed to pay $3 million to resolve claims that it violated the Disadvantaged Business Enterprise (DBE) contracting requirements on federally-funded Texas highway construction projects.

The story was reported by US Newswire on December 14, 2005.

Tuesday, December 13, 2005

New Jersey health care system to pay $3.9 million for Medicare overbilling

The St. Barnabas Health Care System agreed to pay nearly $3.9 million to settle claims it overcharged Medicare, largely by billing for inpatient services when people received only same-day treatment.

The health system consists of nine hospitals, including Community Medical Center in Toms River, Kimball Medical Center in Lakewood and Monmouth Medical Center in Long Branch. The suit was brought under the federal False Claims Act, which allows the government to seek triple damages and penalties for false or fraudulent claims submitted to the government.

Part of the settlement covers claims that St. Barnabas submitted claims containing pneumonia treatment codes that reflected a higher level of care — and therefore a higher level of reimbursement — than was actually provided.

The full story is available in the December 7, 2005 issue of the Asbury Park Press.

Bill would require healthcare providers to educate staff about the False Claims Act

Under a provision in the budget bill passed by the Senate on November 4 (and agreed to by the House on November 18) healthcare providers who receive Medicaid funds would have to educate staff about the False Claims Act. The education requirement would apply to providers who receive at least $1 million in Medicaid funds annually.

The Deficit Reduction Omnibus Reconciliation Act of 2005 would also encourage states to implement their own false claims acts by increasing their share of false claims recoveries.

The False Claims Act has recovered nearly $16 billion since 1986, with more than $1.5 billion in fiscal 2005.

You can read more about the proposed bill in the December 5, 2005 issue of Modern Healthcare.