Saturday, December 27, 2014

Will Lawsuits be a Side Effect of Obamacare?: Easton Hospital agrees to $662,000 federal settlement


Payment resolves health care fraud allegations

Albert Castro/69 News EASTON, Pa. - Operators of Easton Hospital have agreed to a $662,000 settlement with the government to resolve allegations of health care fraud arising under the False Claims Act.

 The U.S. Justice Department contends Easton Hospital billed Medicare for procedures performed by Dr. Thomas Walden that were not performed, were only partially completed or were medically unnecessary. Dr. Walden tells 69 News he never performed procedures that were unnecessary. 

Nor has he billed for procedures he has not performed.  He says he is not involved with what Easton Hospital bills to Medicare.  Quick Clicks Medicare fines area hospitals for high re-admission rates.

Those procedures included extracorporeal shock wave lithotripsy, cystometrogram, green light laser and transurethral resection of the prostate. 

Easton Hospital denies the allegations.

The government maintains that, while employed at Easton Hospital, two former employees discovered a Medicare fraud scheme perpetrated at  the hospital.

 In specific, the employees observed urologic procedures and tests performed by Walden for which the government should not have been billed by Easton Hospital.

 The two employees filed a complaint in the Justice Department's Eastern District of Pennsylvania under whistleblower provisions of the False Claims Act, which permit private citizens to bring civil actions on behalf of the United States.

 The settlement was announced Monday in Philadelphia by U.S. Atty. Zane David Memeger.

 Under the parties’ settlement agreement, Easton Hospital will pay $662,000 to the United States.

The two whistle-blowing employees will receive a share of the settlement payment. 

“The United States Attorney’s Office for the Eastern District of Pennsylvania places a high priority on criminal and civil enforcement in cases involving health care fraud,” said Memeger in a news release.

“Health care fraud wastes tax dollars, harms patients, and drives up medical costs for everyone.

We encourage our citizens to report potential health care fraud so that we can effectively investigate and prosecute this type of wrongdoing.”

 The case was investigated by the U.S. Attorney’s Office for the Eastern District of Pennsylvania, the U.S. Department of Health and Human Services- Office of Inspector General, and the U.S. Office of Personnel Management-Office of Inspector General.

 Within the United States Attorney’s Office, the case was handled by Assistant U.S. Attorneys Veronica J. Finkelstein and Joel M. Sweet.

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