The Medical Center of Southeastern Oklahoma in Durant, and its parent company, Naples, Fla.-based Health Management Associates, have agreed to pay $1.5 million to settle allegations the hospital billed the Oklahoma Medicaid program for surgical procedures that were not medically necessary, according to the Department of Justice.
The lawsuit alleged MCSO submitted claims to SoonerCare, the Oklahoma Medicaid program, for surgeries and other medical services performed by Daniel Castro, MD, that were not medically necessary. The complaint also alleged MCSO submitted claims to the state's Medicaid program for surgeries performed by Dr. Castro, but the surgeries were never actually performed, according to the report.
The lawsuit against MCSO and HMA was originally filed by a former employee of the medical center under the qui tam, or whistle-blower provision, of the False Claims Act, according to the report.
Although MCSO and HMA agreed to settle this lawsuit, there has been no determination of liability, according to the report.
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