Healthcare: Rhode Island Hospital ordered unecessary overnight stays, claimed fees
Rhode Island Hospital will reimburse federal health care schemes approximately USD2.6 million dollars and will pay the federal government approximately USD2.7 million in double and triple damages for ordering medically unnecessary overnight patient hospital stays and then submitting claims for payment to federally funded Medicare and Medicaid schemes.
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Healthcare: Rhode Island Hospital ordered unecessary overnight stays, claimed fees
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An investigation by the United States Attorney’s Office for the District of Rhode Island; Office of Inspector General of the U.S Department of Health and Human Services (OIG-HHS); and the Federal Bureau of Investigation determined that during the period from 1 January, 2004, until 31 December, 2009, medically unnecessary overnight hospital admissions were ordered for approximately 260 patients who underwent stereotactic radiosurgery, otherwise known as Gamma Knife treatment.
The investigation also revealed that Rhode Island Hospital’s claims for reimbursement for the overnight admissions to Medicare and Medicaid falsely represented that the admissions were medically necessary when, in fact, they were not.
According to a Civil Settlement Agreement, OIG-HHS reserves all rights to institute, direct, or to maintain any administrative action seeking exclusion against Rhode Island Hospital and/or its officers, directors, and employees from Medicare, Medicaid, and all other federal health care schemes.
In addition, the Agreement stipulates that the federal government does not release Rhode Island Hospital from any criminal liability or liability to the Internal Revenue Service in this matter.
source: edited from FBI statement
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