HCA hospitals settle Medicare fraud case that could have national implications

An ambulance company and nine hospitals in the Jacksonville, Fla., area, including four operated by Nashville, Tenn.-based HCA Holdings, have agreed to pay $7.5 million to the federal government to settle allegations they fraudulently billed Medicare for medically unnecessary ambulance rides, according to The Wall Street Journal.

The settlement was the result of a four-year investigation into the hospitals and the ambulance company by the U.S. Attorney's Office for the Middle District of Florida. Like HCA, Jacksonville, Fla.-based Baptist Health owns four of the facilities involved in the settlement. The University of Florida's hospital in Jacksonville also agreed to the settlement.

The investigation involving the nine hospitals revealed patients were being transported to the facilities in ambulances when other less-costly methods of transportation were available and more appropriate. For instance, the investigation revealed many patients were receiving nonemergency rides from the hospitals to their homes or to nursing homes, according to the report.

None of the hospitals that agreed to the settlement directly profited from the unnecessary ambulance rides. However, prosecutors determined the nine hospitals indirectly benefitted because the rides sped up admissions and discharges.

All of the hospitals involved in the case denied any wrongdoing. Baptist Health, which is paying a $2.89 million fine, told The Wall Street Journal it agreed to the settlement even though it disagrees with the claims "to avoid the inconvenience and expense of potentially lengthy litigation." HCA agreed to pay a $2.37 million fine, UF Health Jacksonville agreed to pay a $1 million fine, and Century Ambulance — the ambulance company that was the subject of the investigation — agreed to pay $1.25 million to settle the case.

With hospitals across the nation using ambulances to move patients from one location to another without first determining the medical need for the service, federal prosecutors told The Wall Street Journal this case could have national implications.

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10 recent legislative developments affecting healthcare
IU Health hit with $100M false claims lawsuit: 5 things to know

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