The hospital formerly known as St. Joseph Medical Center has reached yet another settlement – this time with the federal government and the state of Maryland. What for this time? This one is for submitting false claims to Medicare, Medicaid, and other federal healthcare programs.
Catholic Health Initiatives, St. Joseph’s former parent company, will pay the $4.9 million in a settlement brought on by unnecessary hospital admissions. St. Joseph, who became part of the University of Maryland Medical System last year, reached the agreement “without admitting liability.” A routine hospital audit in 2010 revealed that from 2007 through 2009, St. Joseph admitted patients to the hospital unnecessarily, typically for one to two day stays. As the treatment was not warranted by the patient’s condition, it caused an over-billing for government health care reimbursements, allowing the hospital to receive more money than it should.
Of the $4.9 million Catholic Health Initiatives will have to pay, $4.75 million will go to the federal government, with the remaining amount to be awarded to the state of Maryland.
St. Joseph had its fair share of legal woes. In early 2010, allegations were made that at least 369 of St. Joseph’s heart patients received coronary stents that were not medically necessary, costing the hospital a whopping $22 million to settle. Also wrapped up in the middle of that mess was a lawsuit filed by the federal government for kickbacks given to St. Joseph for referrals from MidAtlantic Cardiovascular Associates.
These stent cases are just tragic. But the Maryland cases are now beginning to settle and hopefully the people who got these unnecessary operations are doing well. Ironically, while the practice was unsafe, this may have inadvertently been a good thing for some patients who now have a clear part in their arteries.