Florida Hospital in Orlando has repaid $3 million to Medicare, a move seen by prosecutors as corroborating overbilling allegations and by hospital officials as the result of a routine audit, according to an Orlando Sentinel report.
Lawyers representing whistleblowers who filed suit against Florida Hospital in Orlando say the organization's repayment of $3 million to Medicare shows merit to overbilling allegations, but hospital officials say the repayment was the result of a "normal and routine" audit.
Florida Hospital and six other hospitals under the Orlando-based Adventist Health System face allegations of improper Medicare billing. A whistleblower complaint filed in July 2010 and unsealed in August 2012 alleges that seven Adventist hospitals routinely submitted duplicate claims or overbilled for radiology services for 15 years. A second complaint, filed in October 2012, claims fraudulent billing occurred for emergency services, as well.
Marlan Wilbanks, JD, an attorney representing the whistleblowers, says Florida Hospital's recent repayments to the Medicare program "further proves the credibility of our case," according to the report.
But hospital spokesperson Samantha O'Lenick says the repayment was based on a third-party audit's findings. "It is not uncommon for us, as well as others in the industry, to conduct normal and routine audits because of the highly complex governmental billing rules," Ms. O'Lenick said in the report. "Sometimes in doing so, we correct overcharges and undercharges."
A district judge has called the whistleblowers' evidence of the alleged wrongdoing "extensive and sufficient," and denied Florida Hospital's first motion to dismiss the case. He also denied another motion to dismiss the second claim, which was filed more recently.
A trial for the case is set for Dec. 2.
Medical Center of Georgia Sues Blue Cross Blue Shield for Alleged Underpayments
Michigan Hospital Settles Nurse's Racial Discrimination Complaint
Lawyers representing whistleblowers who filed suit against Florida Hospital in Orlando say the organization's repayment of $3 million to Medicare shows merit to overbilling allegations, but hospital officials say the repayment was the result of a "normal and routine" audit.
Florida Hospital and six other hospitals under the Orlando-based Adventist Health System face allegations of improper Medicare billing. A whistleblower complaint filed in July 2010 and unsealed in August 2012 alleges that seven Adventist hospitals routinely submitted duplicate claims or overbilled for radiology services for 15 years. A second complaint, filed in October 2012, claims fraudulent billing occurred for emergency services, as well.
Marlan Wilbanks, JD, an attorney representing the whistleblowers, says Florida Hospital's recent repayments to the Medicare program "further proves the credibility of our case," according to the report.
But hospital spokesperson Samantha O'Lenick says the repayment was based on a third-party audit's findings. "It is not uncommon for us, as well as others in the industry, to conduct normal and routine audits because of the highly complex governmental billing rules," Ms. O'Lenick said in the report. "Sometimes in doing so, we correct overcharges and undercharges."
A district judge has called the whistleblowers' evidence of the alleged wrongdoing "extensive and sufficient," and denied Florida Hospital's first motion to dismiss the case. He also denied another motion to dismiss the second claim, which was filed more recently.
A trial for the case is set for Dec. 2.
More Articles on Hospitals and Lawsuits:
Texas Supreme Court Dismisses Whistleblower Suit Against UT SouthwesternMedical Center of Georgia Sues Blue Cross Blue Shield for Alleged Underpayments
Michigan Hospital Settles Nurse's Racial Discrimination Complaint