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  • Oklahoma Heart Hospital to pay $2.8M to settle false-billing allegations

    Oklahoma Heart Hospital to pay $2.8M to settle false-billing allegations

    Oklahoma Heart Hospital in Oklahoma City will pay $2.8 million to settle allegations of fraudulent Medicaid billing practices, according to NBC-affiliate TV station KFOR.

    Whistleblower Jennifferr Baird , a registered nurse who oversaw a seven-person staff at the hospital in 2015, filed a complaint against the hospital.

    She alleged the hospital consistently billed Oklahoma's Medicaid insurance program for stent procedures at inpatient rates, regardless of whether a physician ordered inpatient care or if the procedure was handled on an outpatient basis, according to a news release from the Employment Law Group law firm, which represented Ms. Baird, and Oklahoma firm Allison Legal.

    "First, OHH routes almost all of its Medicaid patients to inpatient treatment, when many should be classified as outpatient; in doing so OHH is able to charge significantly larger fees for the same treatment. The fraud is evidenced by the fact that OHH does not treat its Medicare or privately insured patients similarly. 

    "Second, OHH fraudulently manipulates its re-hospitalization rate of Medicare patients to induce the government to pay it a bonus," the lawsuit alleged, according to KFOR.

    Federal and state prosecutors allege the fraudulent billing continued for at least seven years.

    The hospital did not admit to Ms. Baird's allegations, but agreed to pay $2.8 million to the federal and state governments to resolve the issue.

    The law firm's news release said the hospital also agreed to follow a new "corporate integrity agreement" that will be enforced by HHS.


    More articles on legal and regulatory issues:

    UNC sues Vidant over hospital board shuffle
    Intermountain drops false claims case it took to Supreme Court
    Physician says fraudster stole his identity to bilk Medicare

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