Hospital pays $20 million to settle Medicare billing fraud case

The Macon-based Medical Center of Central Georgia, the second largest hospital in the state, will pay $20 million to settle allegations that it violated the False Claims Act by billing Medicare for more expensive inpatient services instead of less costly outpatient or observation services.

The feds alleged that from 2004 to 2008 the hospital knowingly charged Medicare for medically unnecessary inpatient admissions when the care provided should have been billed as less costly outpatient or observation services.

Since January 2009, the U.S. Justice Department has recovered more than $24 billion through False Claims Act cases, with more than $15.3 billion of that from cases involving fraud against federal health care programs.

The hospital also will be required for the next five years to have an independent organization review the accuracy of the company’s claims for services furnished to federal health care program beneficiaries.

Jeffrey Newman represents whistleblowers