From 2005 to 2013 the hospital submitted Medicare claims for the group therapy sessions, performed on the hospital’s behalf by Allegiance Health Management, that did not qualify for reimbursement. Allegiance and more than 20 hospitals where it provided services have already entered into settlement agreements.
“Hospitals that participate in the Medicare program are responsible for ensuring that the services performed at their facilities or on their behalf reflect the medical needs of patients rather than the desire to maximize profit,” said acting Assistant Attorney General Chad A. Readler for the Civil Division. “The Department of Justice will continue to hold accountable those who misspend taxpayer funds by providing medically inappropriate services.”
The lawsuit was filed by a whistle-blower who formerly worked for Allegiance.
More articles on legal and regulatory issues:
Physician sentenced to prison for role in $30M billing fraud scheme
Third assisted living worker arrested in case of dementia patient duct-taped to chair
Neurosurgeon claims Wyoming Medical Center violated employment agreement
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
