St. Joseph’s Medical Center in Towson, Md., has reached a settlement with the U.S. to pay $4.9 million in connection with its submission of false claims to Medicare, Medicaid and other federal healthcare programs, according to an announcement from the U.S. Department of Justice (DOJ).
More than 300 cases have been filed on behalf of patients against Mark G. Midei, MD, an interventional cardiologist who had his medical license revoked by the Maryland State Board of Physicians in July 2011, and his facility, St. Joseph Medical Center, for allegedly unnecessarily stenting patients. St. Joseph's previously settled a civil suit for $22 million.
This settlement with the DoJ resolves the hospital’s civil liability to the U.S. under the False Claims Act for the hospital’s disclosure that from 2007 to 2009 it engaged in a practice of admitting patients to the hospital unnecessarily. In particular, the hospital disclosed that it admitted patients for short stays—typically one or two days—that were not warranted by the patient’s medical condition, and thereby generated a larger reimbursement than was proper for each patient.
Of the $4.9 million to be paid by St. Joseph’s, $4.6 million will go the U.S., and $152,406 will go to the state of Maryland, which is also a party to the agreement.
“The improper admission of patients for the purpose of obtaining increased reimbursement is a significant drain on the resources of federal and state healthcare programs,” said Stuart F. Delery, principal deputy assistant attorney general of the DOJ's civil division. “This recovery reflects the department’s continuing efforts to safeguard federal funds.”
This resolution is part of the government's emphasis on combating healthcare fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services, in May 2009.