Delaware hospital to pay $4M to settle improper billing case

St. Francis Hospital in Wilmington, Del., has agreed to pay the federal government and the state of Delaware more than $4 million to resolve improper billing issues, according to the Department of Justice.

The settlement resolves claims that St. Francis improperly billed Medicare and Medicaid for certain services between 2007 and 2010. The government specifically alleged St. Francis violated the False Claims Act by improperly billing for patients admitted into its inpatient rehabilitation unit when admission was not medically necessary and/or the services provided did not fully qualify for reimbursement, according to the DOJ.

In addition, the settlement resolves claims that St. Francis employed an individual who was excluded from participating in any federal healthcare programs.

After St. Francis discovered the issues, the hospital self-disclosed the improper payments to the U.S. Attorney's Office and HHS' Office of Inspector General.

"This resolution is an example of how voluntary self-disclosure benefits both the government and providers who report potential fraud and compliance problems," said Charles M. Oberly III, U.S. attorney for the District of Delaware. "The government was able to recover monetary damages for compliance issues that might not have been revealed without St. Francis' self-disclosure, and St. Francis can move forward without concern about lingering liabilities related to this conduct."

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