WASHINGTON, DC - Adventist Health System Sunbelt Healthcare Corporation and three affiliated hospitals have agreed to pay the United States $8.7 million to settle allegations that the hospitals overcharged Medicare, the Justice Department and the Department of Health and Human Services announced today. The government alleged that at different times from 1992 to 1999 Adventist and its facilities submitted cost reports to Medicare that included inflated management fees for the ambulance services operated by the hospitals.
GCSDA CORRUPTION #85
Adventist Hospitals fined $8.7 MILLION by U.S. Govt for stealing from Medicare
FOR IMMEDIATE RELEASE
FRIDAY, DECEMBER 8, 2000
TDD (202) 514-1888
ADVENTIST HEALTH SYSTEM & AFFILIATED HOSPITALS
PAY NEARLY $9 MILLION FOR OVERBILLING MEDICARE
The Medicare cost reports at issue filed by Florida Hospital Waterman Inc., located in Eustice, Florida, included ambulance management fees paid to Florida Regional Emergency Services and its successor, Regional Emergency Services. The other cost reports, filed by
Huguley Memorial Medical Center in Fort Worth, Texas and Metroplex Adventist Hospital Inc. in Killeen, Texas, included ambulance management fees paid to Western Regional Emergency Services, and its successor, Regional Emergency Services.
"This settlement demonstrates the United States' commitment to protecting federal funds from fraud and abuse," said David W. Ogden, Assistant Attorney General in charge of the Civil Division.
The initial allegations were brought under the qui tam or whistleblower provisions of the False Claims Act by Mark Thornton, a former director of internal audit for a subsidiary of Adventist. Under the qui tam provisions of the False Claims Act, the whistleblower or relator can file an action on behalf of the United States. Under the terms of today's settlement, the relator will receive $1.5 million of the funds.
Under the False Claims Act, any person, including a corporation, who submits, or causes to be submitted, a false claim for reimbursement from Medicare or any other federal program, is liable for three times the amount of damages, plus civil penalties of $5,000-10,000 for each claim.
The case was conducted by the Civil Division of the Department of Justice.
The lawsuit is filed in the Middle District of Florida as United States ex rel.
Mark Thornton v. Adventist Health System Sunbelt Healthcare Corporation , No. 6:97-CV-146-ORL-31C.