Two national healthcare associations are taking Quorum Health Group's side in a pending whistleblower lawsuit that alleges the hospital company committed Medicare fraud by keeping two sets of books for Medicare reimbursement.
The Healthcare Financial Management Association, the industry's membership organization for finance professionals, and the American Hospital Association support Brentwood, Tenn.-based Quorum Health Group's contention that there is nothing inherently fraudulent about keeping reserve work papers and failing to submit them to the government with Medicare cost reports.
The HFMA and the AHA submitted their briefs to the U.S. District Court in Tampa, Fla., on Friday.
The lawsuit alleges Quorum and its hospitals engaged in Medicare fraud by keeping reserve reports detailing padded Medicare claims submitted to fiscal intermediaries.
The HFMA does not take a position on the case itself, but its brief argues that creating reserves is routine among hospitals.
"While this information must be provided if specifically requested, the reserve calculations and work papers are confidential information that is not automatically submitted with the cost report," the brief states.
This counters the plaintiffs' allegation that withholding reserve information automatically renders the filed cost reports fraudulent under the False Claims Act.
The lawsuit, first filed under seal by a whistleblower in 1993, was unsealed and joined by the federal government last October.
Mary Grealy, the AHA's departing chief Washington counsel, said the hospital organization is getting involved because the issue has broad implications for the industry.
"The concern here is that without going through a rule-making process, the government seems to be asserting you cannot have a discrepancy between your filed cost report and those financial statements," she said. "The problem with that is that those are two very different documents for two very different purposes."