Boston Medical Center and two of its physician practices have agreed to pay $1.1 million to resolve allegations that BMC improperly billed Medicaid and Medicare, according to the Department of Justice.
The settlement resolves allegations that BMC billed Medicare for more units of an expensive cancer drug, Rituxan, than it actually infused in its patients. After learning of the investigation, BMC informed the federal government that it had undertaken an audit of the Rituxan issue.
The settlement also resolves allegations that BMC overbilled Medicare and Medicaid for services at its pre-surgical treatment center and submitted claims to Medicare for outpatient podiatry services where clinical documentation did not support the necessity of the services, according to the DOJ.
The allegations were originally brought by Kathleen Haffernan, BMC's former chief compliance officer, under the whistle-blower provision of the False Claims Act.
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