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Iowa Hospital to Pay $1.88 Million to Resolve False Claims Act Allegations Relating to Improper Inpatient Admission Claims | WhistleBlower Resource

Iowa Hospital to Pay $1.88 Million to Resolve False Claims Act Allegations Relating to Improper Inpatient Admission Claims

Genesis Medical Center, an acute care hospital in Davenport, has agreed to pay $1.88 million to the United States to resolve allegations it violated the False Claims Act.

The settlement resolves claims that, from January 1, 2013, to December 31, 2016, Genesis violated the False Claims Act by improperly retaining Medicare overpayments for hospital inpatient admission claims when those claims should have been billed at the lower reimbursement rate for either outpatient or observation services. The False Claims Act claims resolved by this settlement are allegations only and there has been no determination of liability.

“Our office will aggressively use the False Claims Act to ensure all health care providers play by the same rules and taxpayers do not pay the bill for unnecessary services,” said Marc Krickbaum, United States Attorney for the Southern District of Iowa. “This recovery sends the message to health care providers there will be consequences if they fail to comply with state and federal regulations. We also note and appreciate the hospital’s cooperation throughout the investigation.”

The United States Attorney’s Office for the Southern District of Iowa, in conjunction with the United States Attorney’s Office for the Northern District of Iowa, initiated this case. False Claims Act cases can also be brought under the qui tam provisions of the Act, which encourage whistleblowers to bring suit on behalf of the United States and share in any recovery.