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Geisinger will pay $18.5 million to settle false claims it filed to Medicare for hospice and home health services, the Justice Department announced Monday.
Geisinger voluntarily reported the billing mistakes its Geisinger Community Health Services unit committed between 2012 and 2017. Claims regarding physician certifications of terminal illnesses, patients’ elections to enter hospice and in-person physician interactions with home health patients violated Medicare law, according to the Justice Department.
“The $18 million payment in this matter reflects the priority healthcare providers should place on making sure they closely follow all Medicare rules and regulations,” acting U.S. Attorney Bruce Brandler said in a news release. “I commend [Geisinger Community Health Services] for taking this seriously, voluntarily disclosing these issues to our office and working to address the problems that led to these violations.”
Geisinger uncovered the faulty billings during a routine self-audit and promptly took corrective action, the Danville, Pennsylvania-based nine-hospital, not-for-profit system said in a statement.
“Since uncovering these deficiencies, we have conducted follow-up audits that have shown 100% compliance, and we do not anticipate any further billing deficiencies related to these services,” the company said.
The civil settlement amounts to roughly 0.3% of Gesinger’s $7.12 billion in 2020 revenue, which declined slightly from $7.15 billion the prior year. The health system recorded an operating loss of $38.3 million in 2020, down from its $118.8 million of operating income in 2019.
The Justice Department collected nearly $1.86 billion in civil False Claims Act settlements last year. Federal law enforcement obtained at least $2 billion in fraud settlements each year from 2010 to 2019.
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