CHRISTUS Health, a hospital system based in Houston, has agreed to pay almost $1 million to settle allegations that it committed Medicare fraud by falsely billing the federal healthcare program for unapproved medical costs and failing to disclose overpayments, according to a news release by Phillips & Cohen.
The allegations were brought to light by whistleblower Mark Razin, a Healthcare Financial Advisors employee who worked with CHRISTUS on cost reports to maximize Medicare reimbursement. The allegations against the hospital system accuse the health system of committing fraud as far back as 1988, with allegations including wrongful billing to Medicare for advertising, marketing and administrative costs. CHRISTUS also allegedly failed to disclose errors made by a fiscal intermediary that reviewed Medicare cost reports which caused the overpayments. Hospitals are required to report overpayments caused by reimbursement errors to Medicare.
Mr. Razin will receive a portion of the settlement under the qui tam, or whistleblower, provisions of the False Claims Act. Although he filed the lawsuit against CHRISTUS in 1998, the details of the case has been remained sealed until Tuesday when a federal district court judge in Los Angeles decided to unseal the case. Details of whether the health system has admitted to wrongdoing are not disclosed in the news release.
CHRISTUS Health operates more than 40 hospitals and facilities in Texas, New Mexico, Arkansas, Louisiana, Oklahoma, Utah, Missouri and Georgia.
Read the news release about CHRISTUS Health's settlement.
Read other coverage about hospital fraud:
- Indian Health Services Faces Panel After Investigations of Fraud, Theft and Employee Misconduct
- Government to Intervene in Mayo Clinic Investigation
- Unnamed Maryland Hospital Under Investigation for Possibly Performing Unnecessary Procedures
The allegations were brought to light by whistleblower Mark Razin, a Healthcare Financial Advisors employee who worked with CHRISTUS on cost reports to maximize Medicare reimbursement. The allegations against the hospital system accuse the health system of committing fraud as far back as 1988, with allegations including wrongful billing to Medicare for advertising, marketing and administrative costs. CHRISTUS also allegedly failed to disclose errors made by a fiscal intermediary that reviewed Medicare cost reports which caused the overpayments. Hospitals are required to report overpayments caused by reimbursement errors to Medicare.
Mr. Razin will receive a portion of the settlement under the qui tam, or whistleblower, provisions of the False Claims Act. Although he filed the lawsuit against CHRISTUS in 1998, the details of the case has been remained sealed until Tuesday when a federal district court judge in Los Angeles decided to unseal the case. Details of whether the health system has admitted to wrongdoing are not disclosed in the news release.
CHRISTUS Health operates more than 40 hospitals and facilities in Texas, New Mexico, Arkansas, Louisiana, Oklahoma, Utah, Missouri and Georgia.
Read the news release about CHRISTUS Health's settlement.
Read other coverage about hospital fraud:
- Indian Health Services Faces Panel After Investigations of Fraud, Theft and Employee Misconduct
- Government to Intervene in Mayo Clinic Investigation
- Unnamed Maryland Hospital Under Investigation for Possibly Performing Unnecessary Procedures