12 of the Largest False Claims Settlements in 2012

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The following 12 settlements involved alleged False Claims Act violations, exceeded $1 million and were reached by hospitals and/or health systems within the past year. Settlements are arranged in descending dollar value.

1. Tenet Agrees to $42.75M Settlement for Alleged Medicare Overbilling
In April, Dallas-based Tenet Healthcare agreed to a $42.75 million settlement to resolve allegations it overbilled Medicare for inpatient rehabilitation admissions.

2. HCA Agrees to $16.5M Settlement Over Anti-Kickback, False Claims Charges
In September, Nashville, Tenn.-based Hospital Corporation of America, the U.S. Department of Justice and Tennessee agreed on a settlement in which HCA would pay $16.5 million for alleged violations of the False Claims Act and the Anti-Kickback Statute.

3. Morton Plant Mease Health in Florida Resolves False Claims Allegations With $10M
In November, Clearwater, Fla.-based Morton Plant Mease Health Care agreed to pay $10.17 million to resolve allegations it violated the False Claims Act by overbilling Medicare.

4. Freeman Health in Missouri to Pay $9.3M for Alleged Stark Violations
In November, Joplin, Mo.-based Freeman Health System agreed to a $9.3 settlement to resolve allegations that it knowingly compensated physicians in a manner that violated the Stark Law and False Claims Act.

5. Atlantic Health, Overlook Medical Center Settle Overbilling Allegations With $9M
In June, Overlook Medical Center in Summit, N.J., and its parent, Atlantic Health System, agreed to pay roughly $9 million to settle allegations of Medicare overbilling.

6. Westchester Medical Center in New York to Pay $7M for Alleged Medicaid False Claims
In October, Westchester Medical Center in Valhalla, N.Y., agreed to a $7 million settlement to resolve civil fraud allegations that the hospital submitted false claims to Medicaid for nearly 10 years.

7. Universal Health Services Agrees to Pay $6.85M to Settle False Claims Allegations
In March, King of Prussia, Pa.-based Universal Health Services agreed to pay $6.85 million to settle charges it provided substandard psychiatric services to adolescent patients in Virginia.

8. Christus Spohn Health Pays $5.1M to Settle False Claims Allegations
In June, Christus Spohn Health System, based in Kingsville, Texas, agreed to pay a $5.1 million settlement to resolve allegations its hospitals submitted false claims to Medicare.

9. Maury Regional in Tennessee Settles False Claims Allegations With $3.6M
In July, Maury Regional Medical Center in Columbia, Tenn., agreed to a settlement of roughly $3.6 million to resolve False Claims Act allegations, which it voluntarily reported.

10. Excela Health Paid Nearly $2M to Settle Unnecessary Stenting Charges
The state's attorney's office for the Western District of Pennsylvania collected $13.1 million from civil and criminal actions this past fiscal year, and $1.98 million of that came from a settlement with Greensburg, Pa.-based Excela Health over alleged improper stenting.

11. Memorial Health Care in Tennessee to Pay $1.28M for Alleged Stark Law Violations
In August, Chattanooga, Tenn.-based Memorial Health Care System agreed to pay roughly $1.28 million to settle alleged violations of the False Claims Act and other federal laws.

12. Mayo Clinic to Pay $1.26M to Resolve False Billing Allegations
In August, Mayo Clinic agreed to pay $1.26 million to resolve a federal lawsuit claiming it billed the government for surgical pathology services that were never rendered.

More Articles on Hospitals and Legal Issues:

9 Strategies for Robust Healthcare Due Diligence
AHA: Hospitals Losing Too Much Time, Money to "Outdated" Regulations
10 Necessary Points for a Due Diligence Checklist


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