A Kentucky hospital has agreed to pay the Federal government over $10 million in exchange for resolving charges that they submitted fraudulent claims to Medicare.
According to Federal prosecutors, the hospital knowingly submitted claims for reimbursement to Medicare for prescription drugs that did not meet the department’s requirements. They say several of the prescriptions did not conform to requirements that the prescribing physician signed the order confirming medical necessity, affirming that refills were reasonable and necessary, and showing that the drugs ordered by the scrip were, in fact, delivered.
In addition, prosecutors allege violations of the False Claims Act (a/k/a “Lincoln’s Law”). The hospital allegedly offered Medicare beneficiaries free blood glucose testing supplies and waiver of copayments and deductibles for insulin in exchange for filling their scrip at the hospital.
Last week the hospital agreed to pay $10,101,132 to the Federal government to resolve the above claims. In a press release, the assistant attorney general promised to continue to hold healthcare providers accountable when they submit fraudulent claims for prescription drugs to Medicare for reimbursement.
The case was filed under the qui tam, or whistleblower provision of the False Claims Act, which allows whistleblowers to file cases on the government’s behalf and permits the government to take over prosecution of the case if they find it meritorious.
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