A federal judge last week left Columbia, Md.-based MedStar Health Inc. as the only remaining hospital system to face claims it conspired with a revenue-cycle vendor to submit false admissions certifications for patients covered by Medicare.
However, the attorney who brought the case assured me that the case had a much more nationwide scope than just the Washington area’s MedStar. “This is a national case of money over medicine,” Brad Pigott of Pigott & Johnson, PA in Jackson, Miss., told me.
Judge Robert M. Dow Jr. of the U.S. District Court for the Northern District of Illinois March 22 dismissed claims in the suit brought against Houston-based Methodist Health Care System Inc., Little Rock-based Baptist Health Hospitals Inc. and Southeast Health Systems Inc. of Cape Girardeau, Mo.
The case was brought under the False Claims Act by a former employee of MedStar, Cherry Graziosi, who alleged all of the named hospitals worked with the vendor, Chicago-based Accretive Health Inc., to change recommended patient treatments to increase the number of inpatient admissions at the hospitals.
Graziosi alleged the changes were made by individuals who weren’t qualified to judge the medical necessity of an inpatient admission for patients and with an eye toward providing a revenue boost for MedStar. Medicare paid more for inpatient admissions than it did for observation stays.
Dow dismissed all the hospital systems other than MedStar because, he said, Graziosi was only employed by MedStar and thus could only provide concrete evidence about that hospital group’s actions.
Pigott said he expects that the discovery process will lead to his client being able to amend her complaint to add additional claims against those institutions as well as other hospitals not yet named. “We hope to see them again and hope for other hospitals to be held accountable for saying yes to this practice,” he said.
Read my full story about the case here.
Stay on top of new developments in health law and regulation with a free trial to the Health Law Resource Center.
Learn more about Bloomberg Law and sign up for a free trial.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)