Mercy Hospital Settles Whistleblower Lawsuit for $2.79 Million

WASHINGTON – Mercy Hospital Inc. (d/b/a Mercy Medical Center) of Springfield, Mass., has agreed to pay the United States $2,799,462 to settle claims after a whistleblower alleged Mercy Hospital submitted false charges to Medicare.  Specifically, the lawsuit alleged the hospital violated the False Claims Act between 2005 and 2006 by failing to provide, or failing to document that it provided, the minimum number of hours of rehabilitation therapy required under Medicare guidelines.

Under Medicare, inpatient rehabilitation hospitals must provide a minimum amount of rehabilitative therapy to their patients. In June 2007, Mercy disclosed to the Department of Health and Human Services Office of Inspector General that it could not demonstrate that it had provided the required level of therapy. The settlement announced today resulted from the company’s disclosure.

“This settlement demonstrates the Justice Department’s commitment to ensuring that Medicare patients get all of the care that Medicare pays for,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “As this settlement shows, those who come forward to disclose their violations and cooperate with the government will be dealt with fairly.”

 

The case was handled by the Justice Department’s Civil Division and the Office of Inspector General of the Department of Health and Human Services.

This settlement is part of the government’s emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover approximately $2.2 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 have topped $3 billion.

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