A settlement has been reached to resolve False Claims Act allegations against Boston Medical Center.
The allegations arose from a lawsuit that claimed Boston Medical Center billed Medicare for more units of Rituxan than actually infused in its patients; Boston Medical Center billed Medicare and Medicaid for services at its pre-surgical treatment center even though the global fee for the subsequent surgeries covered those same treatments; and Boston Medical Center submitted claims to Medicare for outpatient podiatry services that were not necessary.
Boston Medical Center was proactive in addressing the issue when it was informed of a government investigation. Boston Medical Center stated that it had already reimbursed some funds and was auditing its Rituxan use. Boston Medical Center also stated that it would initiate an audit of pre-surgical billing practices. Boston Medical Center worked cooperatively with the U.S. Department of Health and Human Services, Office of the Inspector General, and the Department of Justice to address the remaining matters at issue.
“Hospitals have a responsibility to ensure that they are billing federal health care programs appropriately,” said U.S. Attorney Ortiz.
The allegations were raised by Boston Medical Center’s former Chief Compliance Officer, Kathleen Heffernan, who filed the lawsuit against Boston Medical Center under the False Claims Act, allowing her to receive a share of any recovery.
