California hospital to pay $10.25M for false claims, physician self-referral scheme

Oroville (Calif.) Hospital agreed to pay $10.25 million to resolve false claims allegations stemming from medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme and erroneous diagnosis code use.

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Oroville Hospital allegedly admitted patients and billed Medicare and Medicaid for more expensive, medically unnecessary inpatient hospital stays, according to a Dec. 12 news release from the Justice Department. 

The hospital also allegedly incentivized inpatient admissions by paying bonuses that took into account volume or value of admissions to physicians who were “in a position to influence whether or not patients were admitted to the hospital,” according to the release. 

Further, Oroville Hospital allegedly submitted claims to Medicare and Medicaid that included false diagnosis codes for systemic inflammatory response syndrome.

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