Massachusetts hospital settles false billing case

Ayla Ellison -

Cooley Dickinson Hospital in Northampton, Mass., has entered into a settlement with the federal government to resolve the allegation that it submitted claims for medically unnecessary testing to Medicare and Medicaid, according to the Department of Justice.

The hospital, an affiliate of Boston-based Partners HealthCare, will pay $11,332 to resolve the lawsuit, which was originally filed by a patient under the qui tam, or whistleblower, provisions of the False Claims Act.

The lawsuit alleged Cooley Dickinson Hospital submitted claims to government payers for medically unnecessary blood tests used to detect tick-borne diseases between July 1, 2014, and June 22, 2017. The hospital's use of tick-borne disease testing panels allegedly caused the issue.

When a clinician selected a testing panel, an order went to Cooley Dickinson Hospital's laboratory to test for all tick-borne diseases programmed into the testing panel. Some of the tests were for diseases caused by ticks that were not likely to be in the geographic region where the patient was bitten. Those claims, which were allegedly not medically indicated by the patient's symptoms, were submitted to Medicare and Medicaid for payment, according to the Justice Department.

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