Denver Health Settles Overbilling Claims For $6.3M
DENVER (CBS4/AP) -- Denver Heath Medical Center has agreed to pay more than $6.3 million to settle allegations that it over billed Medicare and Medicaid by misclassifying some patients it admitted between 2006-2009.
A whistle blower had alleged Denver Health was inappropriately admitting some patients as "inpatient." Medicare and Medicaid reimburse hospitals at a higher amount when a patient is admitted as "inpatient" rather than "outpatient" or in "observation" status.
"This was a case that was brought to the attention of government authorities by a whistle blower, someone who worked for the hospital who thought that patients were inappropriately labeled," said Colorado Attorney General John Suthers.
The person who brought the lawsuit, Joanne Curren, claimed she was terminated in retaliation for coming forward. She also believes fraud was not involved in the billing errors.
"I would say that I believe it was accidental but I wasn't given the chance to see whether it might be something deliberate," said Curren. "I never wanted vengeance or anything. I was just simply wanting to do the right thing."
Denver Health said in a written statement Thursday that it settled to avoid protracted litigation. It says hospital billing is complex, and it was already working on its billing accuracy when it learned prosecutors were examining the issue.
Prosecutors say Colorado will receive about $1.1 million of the settlement proceeds, the U.S. will receive almost $5.2 million, and the whistle blower, Curren, will receive nearly $818,000.
"Whistle blower laws are designed to induce people to bring these things forward because it's to the benefit of the public in general that these things are exposed and the government recovers for any improper billing," said Suthers.
(TM and © Copyright 2012 CBS Radio Inc. and its relevant subsidiaries. CBS RADIO and EYE Logo TM and Copyright 2012 CBS Broadcasting Inc. Used under license. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)
