Healthy Living: Local News
Update: Carthage Hospital, Feds Settle
Story Updated: Jul 10, 2014
One day after the federal government filed a lawsuit against Carthage Area Hospital, the hospital and the federal government announced the matter is settled.
In a statement Thursday afternoon, the hospital acknowledges "errors," and says it has an arrangement to pay back the government over five years. The hospital will pay back $750,000, the amount the government says it lost.
The hospital's statement followed a lawsuit filed Wednesday in federal court in Syracuse, which accused Carthage Area Hospital of double billing for some procedures done at the hospital between 2006 and 2010.
The procedures - about 1,900 - were covered under Medicare. The government accused Carthage Area Hospital of claiming the procedures took place twice - in the hospital's ambulatory surgery center and in the hospital's operating room.
"...Carthage Area Hospital engaged in a pattern and practice of submitting false claims for payment to Medicare," the government said in the lawsuit.
"This damaged the United States by causing it to pay more than the amounts to which it was entitled."
The hospital describes the matter much differently:
"Once the errors were brought to CAH's (Carthage Area Hospital) attention, CAH conducted a self-audit and reported its findings to HHS (the federal Health and Human Services Administration) and the US Attorney.
"The parties then worked collaboratively to structure a payment plan that would allow CAH to return the excess reimbursements over a period of 5 years, permitting the hospital to make the payments in a manner that would not negatively impact its operations."
In its lawsuit, the government claimed the hospital committed fraud, and because of that, the government is entitled to three times the amount it lost. However, in a statement Thursday afternoon, the U.S. Attorney's office in Syracuse said the "unique circumstances" of the case led it to seek only to recover what was lost.
Carthage Area Hospital's statement does not directly address the question of fraud.
"Although the recent complaint filing was deemed necessary by the US Attorney to implement the settlement agreement, the matter was actually fully resolved before the complaint was even filed," according to the hospital's statement.
The hospital's statement notes the overbilling took place during a previous administration.
“Carthage Area Hospital has implemented the necessary procedures to ensure full compliance in the future,” said Richard A. Duvall, the hospital's chief operating officer.
“Health care fraud is a priority of the Department of Justice and this office. This settlement reflects an appropriate resolution of this case in light of the circumstances. We wish to recognize the full cooperation of Carthage throughout this investigation,” said U.S. Attorney Richard Hartunian, in a statement.
The lawsuit was filed the same day the state Department of Health announced the hospital will get $10 million to continue "key services." That money ultimately is coming from the federal government.