In what could be the final batch of settlements from a 5-year-old national investigation, the U.S. attorney in Columbus, Ohio, announced last week that 75 southern Ohio hospitals will pay $22 million to resolve allegations of billing fraud that involved laboratory tests being billed individually rather than bundled. The settlements are related to an ongoing federal investigation that has recovered $46.8 million from 185 Ohio hospitals. The hospitals settled without admitting guilt.
Allegations were first brought in 1996 in what came to be known as the "Ohio Hospital Project," later expanded to a national probe called "Operation Bad Bundle."
Nationally more than 350 hospitals have paid in excess of $85 million in that investigation, which was launched by HHS' inspector general's office. The Ohio Hospital Project looked at how hospitals billed Medicare and Medicaid for clinical lab tests. The government alleged that the hospitals illegally billed health programs at higher reimbursement rates, as though lab tests were performed individually when they actually involved multiple tests performed simultaneously.
In August, the Ohio Hospital Association settled its 5-year-old federal suit challenging the way the government used the False Claims Act and questioning the government's authority and guidance (Aug. 13, p. 14). That settlement allowed hospitals to settle administratively. OHA spokeswoman Mary Yost said the hospitals that are settling won't have to perform the annual audits and detailed compliance reports previously required by the government in other lab unbundling cases.