The following settlements from healthcare providers were announced within the past week, beginning with the most recent.
1. Massachusetts General Pays $1M to Settle HIPAA Violation Allegations
The General Hospital Corporation and Massachusetts General Physicians Organization, representing Massachusetts General Hospital in Boston, has agreed to pay the U.S. government $1 million to settle allegations that the hospital system violated the HIPAA privacy rule. The allegations involved the loss of documents consisting of a patient schedule containing names and medical record numbers for a group of 192 patients, along with billing encounter forms containing the name, date of birth, medical record number, health insurer and policy number, diagnosis and name of providers for 66 of those patients.
2. Albany Medical Center to Pay $4.5M to Settle Nurse Pay Lawsuit
Albany Medical Center (N.Y.) has agreed to pay $4.5 million to settle a federal class-action lawsuit alleging Albany administrators conspired with other local hospital leaders to limit the pay of around 4,000 registered nurses. The lawsuit alleges that the greater Albany-area hospitals were involved in the publication of an annual survey about upstate New York hospital salaries and benefits. The lawsuit also alleges that hospitals kept nursing pay lower than the industry standard.
3. New York's APS Healthcare Pays $13M to Settle False Claim Allegations
Innovative Resources Group, doing business as APS Healthcare Midwest of White Plains, N.Y., will pay $13 million to the federal government and the state of Georgia to settle allegations that it submitted false claims to Medicaid for specialty services not provided. The government alleges that APS submitted false claims to Medicaid through the Georgia Department of Community Health because it did not provide specialty services related to disease management and case management to members of the Georgia Medicaid Management Program from Sept. 2007 through Feb. 2010.
4. Catholic Healthcare West Pays $9.1M to Settle False Claim Allegations
Catholic Healthcare West has agreed to pay $9.1 million to settle allegations that seven CHW hospitals submitted false Medicare claims. The settlement resolves allegations that three hospitals received overpayments due to Medicare processing errors but did not return the funds when the errors were discovered; three CHW hospitals submitted inflated costs for their home health agencies and were overpaid; and one hospital being overpaid for treating a high percentage of patients with end-stage kidney disease for several years, including two years when the hospital was not eligible.
5. New Jersey ASC Physician-Owner Surrenders License For Allegedly Performing Unnecessary Tests
Rey N. Bello, a former neurologist who practiced in West New York and Paramus, N.J., has agreed to permanently surrender his medical license and pay restitution fees to patients' insurance companies for unnecessary testing and other charges. Mr. Bello's voluntarily surrendered his license, effective Jan. 31, instead of standing in a disciplinary hearing before the Board. He is also required to pay $8,138 in restitution to insurance companies along with $10,000 in civil penalties and $19,327 in cost reimbursements to the state, under terms of the settlement.
1. Massachusetts General Pays $1M to Settle HIPAA Violation Allegations
The General Hospital Corporation and Massachusetts General Physicians Organization, representing Massachusetts General Hospital in Boston, has agreed to pay the U.S. government $1 million to settle allegations that the hospital system violated the HIPAA privacy rule. The allegations involved the loss of documents consisting of a patient schedule containing names and medical record numbers for a group of 192 patients, along with billing encounter forms containing the name, date of birth, medical record number, health insurer and policy number, diagnosis and name of providers for 66 of those patients.
2. Albany Medical Center to Pay $4.5M to Settle Nurse Pay Lawsuit
Albany Medical Center (N.Y.) has agreed to pay $4.5 million to settle a federal class-action lawsuit alleging Albany administrators conspired with other local hospital leaders to limit the pay of around 4,000 registered nurses. The lawsuit alleges that the greater Albany-area hospitals were involved in the publication of an annual survey about upstate New York hospital salaries and benefits. The lawsuit also alleges that hospitals kept nursing pay lower than the industry standard.
3. New York's APS Healthcare Pays $13M to Settle False Claim Allegations
Innovative Resources Group, doing business as APS Healthcare Midwest of White Plains, N.Y., will pay $13 million to the federal government and the state of Georgia to settle allegations that it submitted false claims to Medicaid for specialty services not provided. The government alleges that APS submitted false claims to Medicaid through the Georgia Department of Community Health because it did not provide specialty services related to disease management and case management to members of the Georgia Medicaid Management Program from Sept. 2007 through Feb. 2010.
4. Catholic Healthcare West Pays $9.1M to Settle False Claim Allegations
Catholic Healthcare West has agreed to pay $9.1 million to settle allegations that seven CHW hospitals submitted false Medicare claims. The settlement resolves allegations that three hospitals received overpayments due to Medicare processing errors but did not return the funds when the errors were discovered; three CHW hospitals submitted inflated costs for their home health agencies and were overpaid; and one hospital being overpaid for treating a high percentage of patients with end-stage kidney disease for several years, including two years when the hospital was not eligible.
5. New Jersey ASC Physician-Owner Surrenders License For Allegedly Performing Unnecessary Tests
Rey N. Bello, a former neurologist who practiced in West New York and Paramus, N.J., has agreed to permanently surrender his medical license and pay restitution fees to patients' insurance companies for unnecessary testing and other charges. Mr. Bello's voluntarily surrendered his license, effective Jan. 31, instead of standing in a disciplinary hearing before the Board. He is also required to pay $8,138 in restitution to insurance companies along with $10,000 in civil penalties and $19,327 in cost reimbursements to the state, under terms of the settlement.