A federal investigation was prompted by a whistle-blower lawsuit alleging Baptist Health Systems improperly billed Medicare and was subsequently overpaid. According to the suit, the health system submitted claims to Medicare for procedures already covered by another insurer. Baptist Health Systems did not disclose these patients’ other insurers, as required by law, resulting in the alleged overpayments and FCA violations.
Baptist Health Systems cooperated with the federal investigation and conducted an audit of claims going back to 2003. This audit was used to help the government and the health system reach an acceptable settlement.
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