San Mateo County, Calif., will pay the U.S. government $6.8 million to resolve False Claims Act allegations initiated in a whistle-blower lawsuit brought by a former compliance officer for the county-owned San Mateo Medical Center.
In the agreement the county denies the misconduct described. The principal allegation is that the hospital misrepresented on Medicare cost reports that it had at least 100 available acute-care beds in order to qualify for the higher tier of the disproportionate-share hospital program. The government also contends that the hospital failed to fully report mental health services to the California Mental Health Department, and as a result drew federal money for claims that should have been paid by the state.
Its important to note these are complex regulations that have been in flux over time, in particular with respect to the calculation of acute-care beds, said John Nibbelin, deputy county counsel. Its our view that there was a good-faith basis for asserting 100 or more acute-care beds during the years in question. The hospital, according to the American Hospital Association directory, staffs 107 acute beds and another 260 nursing home-type beds.
Ronald Davis, a former compliance officer, filed the whistle-blower lawsuit in 2006 and is set to receive $1 million from the settlement.