Yale-New Haven (Conn.) Hospital agreed to pay $3.8 million to settle allegations that it overcharged Medicare for infusion therapy, chemotherapy administration and blood transfusion services.
Medicare regulations allow payment for only one unit per patient visit, but the 862-bed hospital submitted claims for multiple units at various times over a period from 2000 to 2005. In addition, from 1999 to 2005 Yale-New Haven allegedly submitted claims for outpatient services provided in its oncology infusion service that were not supported by adequate documentation in the medical record, according to court documents. Yale-New Haven did not admit liability.
Both prosecutors and the hospital reached the settlement to avoid the delay, inconvenience and expense of protracted litigation, according to the settlement agreement. In a statement, Yale-New Haven officials said they were pleased with the settlementthe result, in large part, of a proactive, voluntary disclosure by Yale-New Haven Hospital to ensure compliance with Medicare guidelines. -- by Cinda Becker
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