The government alleged CNMC, which rebranded as Children’s National Health System in 2013, violated the False Claims Act by misstating information on cost reports to HHS. HHS and Medicaid programs used the false information to calculate reimbursement rates to CNMC.
Specifically, the government alleged CNMC misreported its available bed count on its application to HHS’ Health Resources and Services Administration under the Children’s Hospitals Graduate Medical Education Program. The government also alleged CNMC filed cost reports that misstated the hospital’s overhead costs, according to the DOJ.
James A. Roark Sr., a former CNMC employee, originally brought the lawsuit under the qui tam, or whistle-blower, provision of the False Claims Act.
Although CNMC has agreed to this settlement, there has been no determination of liability.
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