The hospital agreed to pay $3.77 million to settle allegations that involved charges pertaining to infusion therapy, chemotherapy administration and blood transfusion services. Authorities claim that the organization billed Medicare for multiple units of these services when the program only allows payments for a single unit of infusion therapy and chemotherapy administration per patient, and one unit of blood transfusion services per day.
"The healthcare system relies on hospitals to bill Medicare honestly and accurately," says U.S. Attorney Kevin O'Connor in a prepared statement. "Billing Medicare for inflated charges relating to chemotherapy services and blood transfusion services damages the fiscal integrity of the Medicare program."
The hospital also disclosed, under the OIG's Provider Self-Disclosure Protocol, it had inadequately documented claims pertaining to services provided in its oncology infusion services in patients? medical records, including dispensing medication and conducting laboratory studies without written orders signed by a physician; the protocol encourages such voluntary disclosure.
Under the agreement, Yale-New Haven Hospital does not admit liability. The hospital said in a statement that it was pleased with the settlement, which was "the result, in large part, of a proactive, voluntary disclosure by Yale-New Haven Hospital to ensure compliance with Medicare guidelines.?