Methodist Hospital Gets Hit For Medicaid Fraud

Categories: Courts
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Seal courtesy DOJ
Usually when the Justice Department announces the settlement of a Medicaid-fraud case, it's a small-time operation dealing with wheelchairs or even adult diapers.

Not today.

Today they've nabbed a nearly-$10 million settlement out of Methodist Hospital here for defrauding the federal program.

The US Attorney's office announcement said:

The government alleged that, between January 2001 and August 2003, Methodist improperly inflated charges for inpatient and outpatient care to make its costs for providing such care appear greater than they actually were, and thereby obtain outlier payments from Medicare that it was not entitled to receive.
Way to go, Methodist! We've contacted Methodist for a response and have been holding off until it comes, but apparently it's taking more time than they anticipated to come up with an explanation.

Acting US Attorney Tim Johnson had a statement ready, though: "Our ultimate goal is to make certain that every Medicare dollar is used for the benefit of Medicare recipients. We will
continue in our efforts to assure that is done."

Update: Here's Methodist's statement:

The Methodist Hospital is paying $9.9 million to settle claims on Medicare outlier payments made between 2001 and 2003. The Methodist Hospital is settling the claims to continue focusing on its clinical and academic missions and avoid a lengthy dispute with the government.

Methodist followed all Medicare rules during the time period in question and, in fact, received less money from the Medicare program during this period than it cost to provide the care. The Methodist Hospital has always had a high number of outlier payments because the hospital is an acute care, urban teaching hospital which treats the sickest and most complicated patients from a broad regional and national service area.

Methodist has always been, and continues to be, in compliance with all Medicare rules and regulations.


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