NewJersey.com
Robert Wood Johnson University Hospital in Hamilton has agreed to pay $6.35 million to settle allegations that the facility defrauded Medicare, Justice Department officials said today.
The Mercer County hospital was accused of inflating charges to Medicare patients to obtain bigger reimbursements from the federal government.
The Mercer County hospital was accused of inflating charges to Medicare patients to obtain bigger reimbursements from the federal government.
“Taxpayer dollars should go towards quality health care, not wasted on fraud and abuse,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice.
The hospital denied wrongdoing in the settlement, said Skip Cimino, the facility's president and CEO. "Robert Wood Johnson University Hospital Hamilton has resolved the outstanding Medicare Reimbursement issue with the government and looks forward to continuing its service to the community," he said.
The facility is latest in a string of New Jersey hospitals targeted by a federal Medicare probe, sparked by "whistle blower" lawsuits filed under the False Claims Act.
In 2008, Cathedral Healthcare System, which is affiliated with the Archdiocese of Newark, agreed to pay $5.3 million to settle similar allegations. Two years earlier, Saint Barnabas Health Care System, the state's largest medical network, agreed to pay $265 million.
The cases revolve around supplemental reimbursements to hospitals, called "outlier payments." They are allocated in cases where the cost of care is unusually high.
Congress enacted the supplemental outlier payment system to ensure hospitals had incentive to treat inpatients whose care requires unusually high costs. Prosecutors, however, say the system is easy to manipulate.
“This office is determined to protect the integrity of the Medicare system for the citizens of New Jersey and of the United States,” U.S. Attorney Paul J. Fishman said.
The hospital denied wrongdoing in the settlement, said Skip Cimino, the facility's president and CEO. "Robert Wood Johnson University Hospital Hamilton has resolved the outstanding Medicare Reimbursement issue with the government and looks forward to continuing its service to the community," he said.
The facility is latest in a string of New Jersey hospitals targeted by a federal Medicare probe, sparked by "whistle blower" lawsuits filed under the False Claims Act.
In 2008, Cathedral Healthcare System, which is affiliated with the Archdiocese of Newark, agreed to pay $5.3 million to settle similar allegations. Two years earlier, Saint Barnabas Health Care System, the state's largest medical network, agreed to pay $265 million.
The cases revolve around supplemental reimbursements to hospitals, called "outlier payments." They are allocated in cases where the cost of care is unusually high.
Congress enacted the supplemental outlier payment system to ensure hospitals had incentive to treat inpatients whose care requires unusually high costs. Prosecutors, however, say the system is easy to manipulate.
“This office is determined to protect the integrity of the Medicare system for the citizens of New Jersey and of the United States,” U.S. Attorney Paul J. Fishman said.
