Amended Suit Against Adventist Hospitals in Florida Alleges Overbilling in EDs

A whistleblower suit accusing seven Adventist Health hospitals in Florida of overbilling Medicare for radiology services has been amended to include overbilling in the hospitals' emergency departments, according to an Orlando Sentinel report.

The amendment alleged routine billing fraud occurred in the hospitals' EDs from 2001 through 2008, possibly longer. This includes the alleged submission of duplicate or padded medical claims for emergency services.

The whistleblowers initially filed suit in July 2010, claiming Florida Hospital Orlando used improper coding from 1995 to 2009 and overbilled federal insurers Medicare, Medicaid and Tricare for radiology services. The whistleblowers claim seven Adventist hospitals overbilled by "tens of millions of dollars," according to the report.

Altamonte Springs, Fla.-based Adventist filed its second motion to dismiss the claim this week. The system's first motion to dismiss the case for insufficient evidence was denied by U.S. District Judge John Antoon, who cited the evidence as "extensive and sufficient."

Hospitals that allegedly partook in the overbilling include Florida Hospital Orlando, Florida Hospital Altamonte, Florida Hospital East Orlando, Florida Hospital Apopka, Florida Hospital Celebration Health, Florida Hospital Kissimmee and Winter Park Memorial Hospital.

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