Banner Health To Pay $18 Million To Settle Whistleblower Case Involving False Medicare Claims
Former employee Cecilia Guardiola said she discovered that Banner hospitals billed an "inordinate and improper number of short-stay claims, particularly those for expensive cardiac procedures," according to the Justice Department statement.
Modern Healthcare:
Banner Health To Pay $18 Million To Settle False Claims Act Lawsuit
Banner Health will pay $18 million to settle a federal False Claims Act case accusing the not-for-profit health system of admitting Medicare patients who could have been treated as outpatients, the U.S. Justice Department announced Thursday. The Justice Department accused Phoenix-based Banner of knowingly overcharging Medicare patients and billing Medicare for short-stay, inpatient procedures that should have been billed on a less costly outpatient basis. The claims are for patients seen from November 2007 through December 2016 at 12 of Banner's hospitals in Arizona and Colorado. (Bannow, 4/12)
Arizona Republic:
Banner Agrees To Settle Whistleblower False Claims Act Case For $18M
The settlement resolves allegations that Arizona's largest health provider "inflated in reports to Medicare the number of hours for which patients received outpatient observation care during this time period," according to a statement from the federal prosecutors. (Alltucker, 4/12)
In other news —
The Baltimore Sun:
Pikesville Company Ordered To Pay Nearly $500,000 For Violating Medicaid Fraud Settlement
A Pikesville-based health care company and its owner have been ordered to pay nearly $500,000 after violating a 2014 settlement agreement in a Medicaid fraud case, Attorney General Brian E. Frosh announced Thursday. Bernadette Nwanguma and her firm, A1 Reliable Medical & Healthcare Services Inc., at 222 Milford Mill Road, failed to comply with the terms of a 2014 settlement agreement, the attorney general said in the announcement. The violation resulted in a $491,922 judgment against the company. (Campbell, 4/12)