Morton Plant Mease, Clearwater, Fla., has entered into a $10.1 million settlement with the Justice Department to resolve allegations that it violated the False Claims Act by improperly billing for cardiac-care services.
The whistle-blower case focused on whether certain interventional cardiac and vascular services that had been billed as inpatient stays should have been classified as outpatient or observation stays.
“Morton Plant Mease fully cooperated with the government inquiry,” the four-hospital system said in a statement (PDF)
. “We entered into this settlement agreement to avoid protracted litigation and to resolve claims where the billing status was disputed by the government. There was no admission of liability or wrongdoing in this settlement.”
The system, part of BayCare Health System, added that the care it provided was “reasonable and necessary” and that the decision of whether to admit patients involves “many complex factors.”
“We fully support all efforts to contain Medicare costs,” the statement said. “We always strive to classify patients in the correct billing status.”
Whistle-blower Randi Ferrare, former director of health management services at Morton Plant Mease, will receive more than $1.8 million as part of the government's recovery, according to a Justice Department news release.