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St. Joseph's Hospital of Atlanta will pay $26 million in whistleblower suit

By Qui Tam

Saint Joseph's Hospital of Atlanta Inc. and Saint Joseph's Health System Inc. have agreed to pay $26 million to settle allegations that they defrauded Medicare.

The suit, which originated as a whistleblower suit filed by a nurse who worked at Saint Joseph's, alleged that the hospital violated the federal False Claims Act with regard to billing for inpatient admissions and other services.

Federal prosecutors charged that the hospital submitted Medicare claims between 2000 and 2005 that should have been billed as "outpatient visits" but were instead sent as "inpatient admissions." Inpatient admissions were reimbursed at a higher rate and the hospital received higher payments than it was entitled to.

The whistleblower will receive $4.94 million from the settlement, according to the December 21, 2007 press release issued by the U.S. Attorney's Office.

Full post as published by False Claims Act - Qui Tam on December 26, 2007 (boomark / email).