#improper billing

The owner and operator of a New Jersey billing company will pay a $100,000 penalty after submitting fraudulent Medicare claims for diagnostic tests that were never conducted, marking the first such penalty for a billing company from HHS’ Office of Inspector General. Susan Toy and her company, Millennium Billing, submitted claims to Medicare for a…

Northampton Hospital Company, LLC d/b/a Easton Hospital (“Easton Hospital”) has agreed to resolve allegations relating to improper billing for inpatient procedures performed at Easton Hospital.  Easton Hospital provides inpatient and outpatient healthcare services in Easton, Pennsylvania.  The hospital’s services include cardiovascular, orthopedic, oncology, maternal, child health, pediatric, physical therapy rehabilitation, and mental health services.  In…

Old Towne Physical Therapy LP has agreed to a $710,000 settlement with the government to resolve allegations of health care fraud arising under the False Claims Act.  Old Towne Physical Therapy is an outpatient physical therapy practice that owns three clinics in Delaware.  The United States contends that Old Towne improperly billed Medicare for physical…

An engineer who helped rebuild the World Trade Center claims his former employers charged the Port Authority for what could be millions of dollars in unnecessary labor hours. The bills were for so-called “standby trades hours,” guaranteed payments to senior union members for being on call whether or not they do any physical labor. Between…

The United States announced today that it has settled claims under the False Claims Act with St. Francis Hospital for improperly billing Medicare and Medicaid for patients admitted into its inpatient rehabilitation unit in Wilmington, Delaware between 2007 and 2010, when admission was not medically necessary and/or the services provided did not fully qualify for…

How does a clinical laboratory company grow in a few short years from nothing to more than $400 million in revenue and over $100 million in profit? Since the same company just settled with the DOJ for as much as $100 million, it’s reasonable to suspect that growth was probably not entirely legitimate. Now new information, gleaned…

A federal lawsuit accuses the Cleveland Clinic Health System of performing more tests and procedures on patients than necessary in order to obtain more Medicare payouts. The lawsuit, which was filed under seal in March 2014 but unsealed on Tuesday, says the health system performs tests “that have already been done to confirm a diagnosis…