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Originally published February 07, 2013

Md.’s St. Joseph Hospital to Pay $4.9M for Making False Healthcare Claims

by AFRO Staff

    St. Joseph's Medical Center (Courtesy Photo)
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St. Joseph’s Medical Center in Towson, Md. will pay $4.9 million under a settlement reached for false claims it made to several federal healthcare programs, the U.S. Attorney’s Office for the District of Maryland announced Feb. 7.

According to the U.S. Attorney’s Office, St. Joseph’s admitted to authorities that, between 2007 and 2009, it unnecessarily processed patients to the hospital for short stays of one or two days which were not warranted by the patient’s condition. In doing so, the hospital earned a larger reimbursement from Medicare, Medicaid, and other federal programs than was proper.

Of the $4.9 million to be paid by St. Joseph’s, $4.75 million will go the United States, and $152,406 will go to the State of Maryland, which was also a party to the agreement.

“Medical providers drain the resources of federal and state health care programs when they bill the government for unneeded medical procedures,” U. S. Attorney for the District of Maryland Rod J. Rosenstein said in a statement.

The settlement came as part of the efforts of the federal Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, created in May 2009. A partnership between the Department of Health and Human Services and the Department of Justice, the group has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.

Part of the HEAT initiative’s efforts is the False Claims Act, a Civil War-era law which the Justice Department has used to recover more than $10.2 billion since January 2009 in cases involving fraud against federal health care programs.

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