Hospital company pays $8 million to settle allegations it kept patients longer than necessary

by Ben Vernia | July 29th, 2013

On July 26, the Department of Justice announced that a long-term acute care hospital company had agreed to pay $8 million to resolve a whistleblower’s charges that it had obtained additional compensation from Medicare by keeping patients longer than was necessary. According to DOJ’s press release:

Dubuis Health System and Southern Crescent Hospital for Specialty Care, Inc. (Southern Crescent) have agreed to pay the United States $8,000,000 to settle allegations that they submitted false claims to Medicare, the Justice Department announced today. Dubuis Health System manages long-term acute care hospitals in multiple states, including Southern Crescent. Southern Crescent is a long-term acute care hospital located in Riverdale, GA and is part of the CHRISTUS Health System.

Long term acute care hospitals are similar to typical acute care hospitals except that they are certified to focus on patients with more complex medical needs who, on average, remain in the hospital more than 25 days. Long term acute care hospitals receive a higher rate of Medicare reimbursement than do typical acute care hospitals. This settlement resolves allegations that between 2003 and 2009, Dubuis Health System and Southern Crescent knowingly kept patients hospitalized beyond the time considered to be medically necessary, to increase their Medicare reimbursement and to maintain Southern Crescent’s classification as a long-term acute care facility.

The Department announced that the whistleblower, a former hospital administrator, will receive $2,167,000 of the settlement (a 27% share).

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