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Calif. County to Pay U.S. $6.8 Million for Allegations of False Medicare, Medicaid Claims

By Nolan and Auerbach

The U.S. Department of Justice announced March 12, 2009, that San Mateo County, Calif., will pay the United States $6.8 million to resolve allegations that the San Mateo Medical Center (SMMC) submitted false claims to the United States in connection with payments from the Medicare and Medicaid programs.

The government alleges that SMMC engaged in Medicare Fraud by falsely inflated its bed count to Medicare in order to receive higher payments under Medicare’s Disproportionate Share Hospital (DSH) adjustment. The government also alleges that San Mateo County improperly obtained federal payments under the Medicaid program for services provided to patients at Institutes of Mental Disease (IMDs) who were between the ages of 22 and 64. This is once again an example of a case where the simple manipulation of a few numerals results in overpayments of millions of dollars. The lawsuit was filed under the qui tam or whistleblower provisions of the False Claims Act by a former employee of San Mateo County.

For a copy of the full press release, http://www.usdoj.gov/opa/pr/2009/March/09-civ-224.html. For more information about qui tam whistleblower law, contact Nolan and Auerbach, PA.

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Full post as published by Medicare Fraud 101 on March 18, 2009 (boomark / email).