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Mo. Healthcare Facility to Pay $60M

Posted on: Tuesday, 22 July 2008, 21:00 CDT

A Missouri healthcare facility will pay $60 million for allegedly engaging in improper Medicare billing practices, the U.S. Justice Department said Tuesday.

Lester E. Cox Medical Centers of Springfield was accused of violating the False Claims Act, the Anti-Kickback Statute and the Stark Statute between 1996 and 2005. The not-for-profit healthcare organization allegedly entered into financial relationships with referring doctors at a local physician group and engaged in improper billing practices with respect to Medicare, Justice Department officials claimed.

The Stark Statute prohibits billing the federal healthcare program for referrals from doctors with whom the providers have financial relationships, except in certain situations. The government contended Cox and the physicians ran afoul of the Anti-Kickback Statute, which prohibits offering inducements to providers in return for patient referrals, and the Stark statute.

Cox also allegedly included non-reimbursable costs on its Medicare cost reports and improperly billed for services provided to dialysis patients.

As part of the settlement, Cox agreed to measures meant to ensure compliance with Medicare regulations and policies in the future.


Source: United Press International

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