Charleston (W.Va.) Area Medical Center, part of the three-hospital, 765-bed Charleston Area Medical Center Health System, agreed on Monday to pay $1.3 million to resolve False Claims Act allegations that the facility defrauded Medicare and Medicaid. The U.S. attorney in Charleston alleged that the hospital falsely billed for individual outpatient physical therapy sessions from 1999 to 2001 to obtain higher reimbursements, when those services actually were delivered in group therapy settings at a lower reimbursement rate. The hospital signed a five-year corporate integrity agreement. The case was investigated by the FBI, West Virginia Medicaid Fraud Control Unit and HHS' inspector general's office.
Hospital President and CEO David Ramsey denied any wrongdoing and said the hospital cooperated fully in the investigation. Ramsey said the hospital settled "to avoid the delay, uncertainty, inconvenience and expense of protracted litigation." He said resolving the allegations allows the hospital to focus on its mission to provide quality healthcare services. -- by Mark Taylor