Southern Illinois University in Carbondale has paid $300,000 to settle allegations that its medical school improperly billed the state's Medicaid program for psychotherapy services.
Federal investigators alleged the school was billing Medicaid for psychiatric services provided solely by residents, which is against state law. A supervising physician must have a hand in the treatment if it is to be reimbursed by Medicaid.
SIU did not admit to wrongdoing or liability as part of the settlement. University officials declined to comment for this story.
The SIU case, which examined the period from 1988 to 1994, predates the Physicians at Teaching Hospitals project, a 2-year-old HHS initiative that looks at how teaching hospitals and their faculty practice physicians bill Medicare for the work of medical residents.
To date, four medical schools and their related teaching hospitals have settled PATH audits for a total of $68 million.
Linda Wawzenski, the assistant U.S. attorney who handled the case, declined to comment on whether the SIU investigation was aided by a whistleblower.
As part of the settlement, SIU agreed to put in place a compliance program and provide continuing education on billing issues for its employees. The school also must keep up to four years' worth of files on hand for inspection.
In related news, the Association of American Medical Colleges and the American Medical Association last week appealed the decision of U.S. District Judge Carlos Moreno in Los Angeles, who dismissed their PATH lawsuit in April.
The lawsuit contested the way government investigators were conducting the PATH audits, accusing them of illegally applying Medicare rules retroactively. Moreno dismissed the case in a brief hearing, saying the plaintiffs had options other than litigation to address their concerns.
The appeal was filed June 23 in the 9th U.S. Court of Appeals in San Francisco.