Worcester, Mass.-based UMass Memorial Medical Center will pay the state $66,000 to resolve allegations it improperly sent bills for uninsured patients to a homeless shelter so it could then submit bills to a state program for payment, according to a Boston Globe report.
The allegations stem from a whistleblower suit filed by a former collections analyst at the hospital. The suit claimed UMass Memorial established a sham patient address and created a paper trail of dunning notices to the address, which was actually that of People in Peril homeless shelter, according to the report.
The whistleblower complaint alleged the hospital sent three letters per patient to the shelter within 120 days, with a fourth letter sent by certified mail. All letters went unanswered, according to the complaint, since the patients did not reside at the shelter.
By allegedly sending bills to the shelter, UMass Memorial could then submit bills to Massachusetts' Health Safety Net office for reimbursement. Health Safety Net is a program for state residents who are uninsured or are not eligible for health insurance. Under certain circumstances, the program reimburses medical facilities for care provided to uninsured patients.
The whistleblower complaint originally included the federal government as a plaintiff, but the government investigated the case and declined to pursue it, according to the report.
"UMass Memorial Medical Center has denied all allegations and has fully cooperated with the Massachusetts attorney general's office in this matter, which is now fully resolved with a minimal payment," hospital spokesperson Margaret Thrappas said in a statement to the Boston Globe.
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