Cooper University Hospital will pay a $3.85 million fine to settle allegations of Medicare fraud, the U.S. Justice Department announced yesterday.
The hospital was accused of increasing charges to Medicare patients to boost its reimbursement from the federal health-care program.
Cooper denied any wrongdoing and said it “did not game this system.”
The Justice Department said in a separate release that from January 2001 to August 2003, Cooper improperly inflated charges for both inpatient and outpatient care so that it could obtain higher amounts of “outlier payments.”
Those payments, the department said, are intended if the cost of care – such as that required in an intensive-care unit – is “unusually high” and are designed as an incentive to hospitals to provide those services.
Cooper, in its statement, said it performed a great amount of uncompensated charity care, “receiving notoriously poor governmental program payments,” and had actually lost money on Medicare reimbursements during the period noted in the accusations.
The civil settlement resolves allegations against Cooper originally brought in a suit by Anthony Kite. Under the False Claims Act, private citizens may bring lawsuits on behalf of the federal government. Under the settlement, Kite will receive $654,500. Charles Miller, a spokesman for the Justice Department’s Civil Division, said Kite was a financial consultant with no apparent connection to the hospital.
A PDF version of the 2011 Medicare fraud settlement can be found HERE