Medicare False Claims Result in $900,000 Settlement by Baylor University

Baylor University Medical Center, Baylor Health Care System and HealthTexas Provider Network (collectively, “Baylor”) have agreed to pay a $907,355 settlement for allegedly submitting false claims and double billing Medicare, the Civilian Health and Medical Program of the Uniformed Services (TRICARE) and the Federal Employees Health Benefit Program (FEHBP) between 2006 to May 2010.

According to the Department of Justice, Baylor submitted false claims for several radiation treatments, and billed for high-reimbursement  oncology procedures when it could have billed cheaper services. Additionally, Baylor submitted billing for procedures lacking the required supporting documents in the patient’s medical records and improperly billed for radiation services without adequate corroboration from physician supervisors.

Stuart F. Delery, Principal Deputy Assistant Attorney General for the Justice Department’s Civil Division, said:

“Physicians who participate in Medicare must bill for their services accurately and honestly… The Department of Justice is committed to ensuring that federal health care funds are spent appropriately.”

This lawsuit is part of an ongoing effort by the Department of Justice and the Department of Health and Human Services to combat medical billing fraud under the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative.

The Employment Law Group® law firm’s whistleblower attorneys have helped many clients file suit against employers that fraudulently bill the U.S. government, and have established favorable precedents under the retaliation provision of the False Claims Act.

Tagged: False Claims Act (FCA), Fraud Types, Medicare Fraud, Whistleblower Laws (Federal)