HOUSTON (CN) – Christus Spohn Health Systems paid $5.1 million to settle allegations its hospitals billed Medicare at inpatient prices for outpatient surgeries, and the whistle-blower will get 20 percent of it, the U.S. Attorney’s Office said.
The settlement resolves claims about billing practices of six Christus Spohn hospitals in and around Corpus Christi.
A False Claims Act lawsuit filed under seal by a former Christus Spohn hospital case management director in March 2008 led to the settlement, prosecutors said.
“The allegations stated that these hospitals were routinely billing outpatient surgical procedures as if they required an inpatient level of care, which greatly increased the amounts paid to these hospitals by the Medicare program,” the U.S. Attorney’s Office said in a statement. “These patients were often discharged from the hospital in less than 24 hours.”
The whistleblower will get 20 percent of the $5.1 million recovery, prosecutors said.