Baptist Health Systems pays $2.5 to settle qui tam charges involving Jacksonville, Florida hospital

by Ben Vernia | May 6th, 2014

On May 6, the Department of Justice announced that Baptist Health Systems had agreed to pay $2.5 million to resolve allegations, originally brought by a whistleblower, that its hospital in Jacksonville, Florida, submitted claims for unnecessary medical services. According to DOJ’s press release:

Baptist Health System Inc. (Baptist Health), the parent company for a network of affiliated hospitals and medical providers in the Jacksonville, Florida, area, has agreed to pay $2.5 million to settle allegations that its subsidiaries violated the False Claims Act by submitting claims to federal health care programs for medically unnecessary services and drugs, the Department of Justice announced today. The alleged misconduct involved Medicare, Medicaid, TRICARE and the Federal Employee Health Benefits Program.

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This settlement resolves allegations that, from September 2009 to October 2011, two neurologists in the Baptist Health network misdiagnosed patients with various neurological disorders, such as multiple sclerosis, which caused Baptist Health to bill for medically unnecessary services. Although Baptist Health placed one of the physicians at issue on administrative leave in October 2011, it did not disclose any misdiagnoses to the government until September 2012.

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The improper conduct at issue in this case included Medicaid patients. Medicaid is funded jointly by the states and the federal government. The state of Florida, which paid for some of the Medicaid claims at issue, will receive $19,024 of the settlement amount.

DOJ also announced that the whistleblower, a former hospital employee, will receive $424,155 (a 17% relator’s share).

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