Piedmont Healthcare has agreed to pay $16 million to settle a whistleblower lawsuit that claimed the system overbilled Medicare and Medicaid for cardiac care and illegally paid kickbacks to practitioners who referred heart patients to its hospitals, the Justice Department announced Thursday.
To get higher payments from the federal health programs, Piedmont over a five-year period admitted thousands of patients to its hospitals for cardiac procedures that could have been performed on an outpatient basis, according to the original complaint filed in federal court in Atlanta.
Piedmont also was accused of acquiring medical practices at grossly inflated prices and paying doctors above-market salaries to induce them to steer patients to Piedmont facilities.
“Billing the government for unnecessary inpatient services wastes precious government resources and taxpayer dollars,” U.S. Attorney Byung J. “BJay” Pak said in a written statement.
Derrick L. Jackson, special agent-in-charge of the U.S. Department of Health and Human Services Office of the Inspector General, said such “greed-fueled” schemes “undermine the public’s trust in the health care industry.”
In agreeing to the settlement, Piedmont did not admit to wrongdoing. It issued a statement saying that the overbilling stemmed from nationwide confusion over whether patients in the hospital should be classified as observation status […]
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