 St
Barnabas Hospital Pays $265 Million
St. Barnabas Healthcare, a nonprofit chain of eight
hospitals in New Jersey, has agreed to pay $265
million
to settle a False
Claims Act lawsuit filed by three whistleblowers.
The case dealt with "outlier" Medicare payments
which a hospital can claim if a procedure is
particularly difficult or complex.
St. Barnabas generated
41% of its total inpatient Medicare
revenue from outlier payments as compared to the
national average of 4.75%. The government estimated
damages in the case at $630 to $700 million, but the
settlement was based on St. Barnabas' ability to
pay. >>
To read more >>
To read the complaint |
The Scope of Outlier Payment
Chicanery
The $265 million St. Barnabas settlement (see above
story) may be just the edge of the wedge on outlier
payments. Some
hospitals and hospital chains found they could
easily manipulate Medicare in order to generate
millions of dollars in phony claims. Along with
Tenet Healthcare, where a "global" settlement of
well in excess of a billion dollars is reportedly in
the works, consider these numbers:
- Robert Wood
Johnson University Hospital at Hamilton (N.J.)
received $18.2 million in outlier payments,
representing 44.2% of its inpatient Medicare
revenue;
- Kimball
Medical Center in Lakewood, N.J., received 63%
of its inpatient Medicare revenue from outlier
payments -- more than any other hospital.
- Four-hospital
Cathedral Healthcare System, in Newark, received
$30.4 million, or 26.6% of its Medicare
inpatient revenue from outlier payments;
- Hackensack
(N.J.) University Medical Center, received $35.6
million, or 20.4% of its Medicare inpatient
revenue from outlier payments;
- Methodist
Hospital in Houston netted $41.4 million, or
23.8% of its Medicare inpatient revenue from
outlier payments;
- Crozer-Keystone
Health System in Springfield, Pa., received
$38.5 million, or 32.1% of its Medicare
inpatient revenue from outlier payments
|
 TAF's
Moorman at ABA Institute
On June 15th, Jim
Moorman, President of Taxpayers Against Fraud, spoke at the
6th ABA National Institute on the False Claims Act.
The title of his lunch-time presentation: The
Whistleblower's Experience: The High Cost of
Integrity. >>
To read the speech
|
Honeywell
to Pay $2.6 Million