Four Health Systems Settle Improper Billing Allegations
In recent news, four prominent health systems have agreed to settle allegations of improper billing. This includes Penn State Health, Pomona Valley Hospital Medical Center, NewYork-Presbyterian Hospital, and Moffitt Cancer Center. The settlements range from $801,000 to over $19.5 million, based on allegations that include overbilling, improper billing for annual wellness visit services, prescription medications, radiology practices, and clinical trial costs. Notably, all the health systems disclosed the discrepancies voluntarily, took proactive corrective measures, and agreed to compensate for the alleged irregularities to resolve the allegations.
Penn State Health’s $11.7 Million Settlement
Penn State Health agreed to pay more than $11.7 million for submitting unsupported claims for annual wellness visit services. The health system discovered and voluntarily reported that it had improperly submitted claims for services not supported by medical records. This marks the second time in less than a year that Penn State Health has agreed to a settlement over self-reported violations of Medicare rules and regulations.
Allegedly, the improper billings to Medicare for annual wellness visit services violated the rules and regulations between December 2015 and November 2022. In addition to the $11.7 million settlement, Penn State Health has agreed to resolve any civil liability for violating Medicare rules and regulations.
Pomona Valley Hospital Medical Center’s Overbilling
Pomona Valley Hospital Medical Center has agreed to pay over $2 million for overbilling the state’s Medicaid program for prescription medications. The agreement is a part of the broader effort to ensure that healthcare systems adhere to strict billing guidelines and maintain transparency in their operations.
NewYork-Presbyterian Hospital’s Settlement
NewYork-Presbyterian Hospital has settled for $801,000 for improperly billing federal healthcare programs for images used in radiation therapy treatments. The improper billing practices came to light after an internal audit, and the hospital took immediate corrective action to rectify the situation.
Moffitt Cancer Center’s $19.5 Million Settlement
Moffitt Cancer Center has agreed to pay over $19.5 million for improperly billing federal healthcare programs for clinical trial costs. The settlement was reached after the center disclosed the discrepancies voluntarily. The center has since taken steps to rectify the situation and prevent such incidents from happening again in the future.
The settlements across the four health systems showcase the importance of transparency, proper billing practices, and adherence to federal and state healthcare program guidelines. It serves as a timely reminder to all healthcare providers about the importance of compliance with billing rules and regulations and the severe repercussions that can come from such discrepancies.