Heart Hospital Pays $1.1 Million in False Claims Settlement

Heart Hospital Pays $1.1 Million in False Claims Settlement

17/05/2022

Oklahoma Heart Hospital South, LLC (OHHS) has paid roughly $1.1 million to settle claims that it submitted false claims to Medicare, the US Department of Justice (DOJ) has announced.

OHHS owns and operates the Oklahoma Heart Hospital South, an acute care hospital located in Oklahoma City.

After an internal review and audit, OHHS discovered irregularities related to its billing of certain services, and proactively contacted the federal government to disclose the problems.

The government then launched an investigation into the disclosures and issues raised by OHHS.

“Throughout the investigation, and to its credit, OHHS cooperated with the United States Attorney’s Office and the US Department of Health and Human Services Office of Inspector General in the investigation,” the DOJ says in a statement.

The investigation revealed that from June 1, 2013 through May 31, 2019, OHHS submitted claims to Medicare for intensive cardiac rehabilitation (ICR) services provided to Medicare beneficiaries.

Before billing Medicare for these services, OHHS was required to have a physician complete and sign an individualized treatment plan (ITP) for the patient. If the patient was to receive ICR for more than 30 days, a physician must complete and sign updates to the ITP every 30 days thereafter.

However, the government alleges that claims for ICR services submitted by OHHS to Medicare for payment violated the False Claims Act because a physician did not complete and/or sign ITPs and/or ITP updates for certain Medicare beneficiaries.

To resolve the claims, OHHS agreed to pay $1,151,770.50 to the US government.

“In reaching this settlement, OHHS did not admit liability, and the government did not make any concessions about the legitimacy of the claims. The agreement allows the parties to avoid the delay, expense, inconvenience, and uncertainty involved in litigating the case,” the DOJ says.

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