Another hospital has settled allegations that it filed false Medicare claims connected with a controversial "billing enhancement" consultant.
Bradford (Pa.) Regional Medical Center paid $495,000 to resolve charges that it billed Medicare fraudulently for clinical laboratory outpatient services. Under the settlement, the 206-bed hospital admitted no wrongdoing. Bradford signed the settlement with HHS' inspector general's office in June.
Bradford is the 23rd hospital to settle Medicare fraud allegations connected with what are called "Metzinger claims cases." HHS' inspector general's office said the hospitals have paid $7.8 million since 1995, with 40 cases still pending.
Bradford is one of more than 200 hospitals in 17 states that hired Voorhees, N.J.-based Metzinger and Associates. The now-defunct consulting company instructed hospitals about how to maximize Medicare reimbursement, mostly through lab services billings, from 1989 to 1994. Hospitals, in turn, paid Metzinger a share of the additional Medicare revenues that stemmed from the company's recommendations.
In 1994, the U.S. Justice Department sued Metzinger in U.S. District Court in Philadelphia, charging that the company advised hospitals to submit claims for tests that often weren't requested or even performed.