Texas hospital to settle allegations of upcoding

John Peter Smith Hospital in Fort Worth, Texas, agreed to settle allegations that it upcoded healthcare claims submitted to federal programs, the Department of Justice said Aug. 27.

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The allegations stem from a 2018 whistleblower lawsuit filed by the hospital’s former director of compliance, Erma Lee. Ms. Lee accused John Peter Smith Hospital of routinely modifying billing codes for hundreds of claims in a way that doubled payment for some aspects of patient care. 

John Peter Smith Hospital agreed to settle the allegations for more than $3 million. 

The accusations were filed under the “qui tam” provision of the False Claims Act.

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