The Nashville Business Journal reports that Tennessee-based Wayne Medical Center has entered into an agreement with the Federal Government to settle False Claims Act allegations, which were actually self-reported by Wayne Medical Center. Wayne Medical Center has agreed to pay $883,451 as part of the settlement. The improper claims relate to ambulance services of the hospital, and include providing medically unnecessary services, improperly documented services, and lack of the requisite signatures.
As I have written about previously, the False Claims Act [FCA] (31 U.S.C § 3729 et seq.) penalizes those who defraud the government. For example, the FCA imposes civil penalties for making false claims for payments to the government, using false records to support a false claim, or receiving compensation from the government but delivering less than the proper amount to the intended recipient.
The penalties under the FCA are severe, and a civil penalty up to $11,000 may be assessed for each false claim. The government may also seek treble damages for each violation. The Justice Department has increasingly used the FCA to recover large sums of money. In Nashville, which is part of the Middle District of Tennessee, the the Middle Tennessee office for the U.S. Attorney secured more than $100 million in recoveries or settlements from health care fraud actions in 2011.
As an added punishment, violators of the FCA may be excluded altogether from federal health care programs such as Medicare and Medicaid. (42 U.S.C. § 1320a-7(b)).