December 1st, 2008
Jackson Madison General Hospital to Pay $2,568,280.00 And Milan General Hospital to Pay $5,309,494.00 To Settle False Claims Allegations
Jackson, TN - Two West Tennessee hospitals have entered into agreements with the Department of Justice to resolve allegations that they submitted false claims to Medicare announced Lawrence J. Laurenzi, Acting United States Attorney for the Western District of Tennessee. Jackson Madison General Hospital, located in Jackson, Tennessee, has agreed to pay the United States $2,568,280 to settle civil allegations associated with the submission of claims for non-emergency ambulance transportation. The government alleged that between July 1, 1997 to June 31, 2002, Jackson Madison submitted claims to Medicare for non-emergency transports for its beneficiaries that did not meet Medicare’s medical necessity and documentation requirements.
In the case against Milan General Hospital, located in Milan, Tennessee, the hospital has agreed to pay $5,309,494 to settle civil allegations for conduct relating to claims submitted to Medicare for inpatient services provided in the geriatric-psychiatric unit. The government asserted that between July 1, 1999 to December 2003, the hospital improperly admitted certain Medicare patients into its psychiatric unit, and that the hospital billed Medicare for lengths of stay in units that exceeded Medicare coverage criteria.
The Justice Department contended that the Medicare claims submitted by Jackson Madison General Hospital and Milan General Hospital violated the Federal False Claims Act. “The settlements announced today further demonstrate that the United States will vigorously investigate and pursue cases to recover tax dollars lost through the submission of the false Medicare claims,” said Lawrence Laurenzi. He continued, “These settlements with Jackson Madison General and Milan General should serve as a warning to other health care providers who seek to defraud medicare or any other federal health care programs.”
As part of the settlements, the Jackson Madison County General Hospital District also agreed to enter into Corporate Integrity Agreements with the U.S. Department of Health and Human Services, Office of Inspector General.
The cases were investigated by the U.S. Attorney’s Office for the Western District of Tennessee, with support from the U.S. Department of Health and Human Services, Office of Inspector General. Assistant United States Attorney Kevin P. Whitmore represented the United States.
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