MID-CITY — For seven years Saint John’s Health Center filed false, inflated claims to Medicare and now must by the federal government $5.25 million as part of a settlement finalized Wednesday, according to the United States Attorney’s Office.
Medicare is a social insurance program administered by the U.S. government, providing health insurance coverage to people who are 65 and over, or who meet other special criteria.
Federal attorneys alleged that Saint John’s engaged in “turbocharging,” meaning that it dramatically increased the charges billed to Medicare for care provided to hospital inpatients far in excess of any increase in the costs associated with that care.
By allegedly turbocharging from 1996 through 2003, Saint John’s was able to obtain significant amounts of Medicare outlier payments that it was not entitled to receive, said Assistant U.S. Attorney Cathy J. Ostiller, who led the investigation.
Saint John’s agreed to resolve the case without having to admit to any wrongdoing. The hospital has agreed to pay the settlement by Aug. 30.
Representatives from the hospital said reviews of Medicare outlier payments are not uncommon, particularly in light of the government’s need to manage spending for federally-funded health programs.
“Saint John’s has worked cooperatively with the federal government throughout its review of the hospital’s past outlier payments and we are pleased to have reached a conclusion on this matter,” a statement from the hospital said. “Saint John’s remains focused on our primary mission to provide breakthrough medicine and inspired healing to the communities we serve.”
Ostiller would not comment on how the settlement figure was reached.
The investigation began in 2006 following a similar probe into Tenet Healthcare Corp., operator of the nation’s second-largest hospital chain. Tenet in 2006 agreed to pay the U.S. more than $900 million to resolve whistleblower lawsuits and investigations alleging Tenet and its hospitals knowingly submitted false claims to the Medicare program and other federal health insurance programs over the past decade.