November 06, 2008
St. Joseph Healthcare System Inc. has agreed to pay the federal government $1.75 million to settle a whistleblower lawsuit alleging the hospital defrauded Medicare by improperly inflating its reimbursement claims. The inflation allowed the hospital to receive “outlier” payments, which the Medicare program makes to hospitals when the actual costs for treating a particular patient greatly exceed a predetermined reimbursement amount for that type of treatment.
The whistleblower, Anthony Kite, an independent hospital consultant, was represented by Larry P. Zoglin of Phillips & Cohen.