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Iowa's Genesis Medical Center hit with $1.88 million settlement over Medicare overpayments

Hospital legal spokesman blamed complex interpretation billing classification rules, said hospital cooperated fully with DOJ investigation.

Beth Jones Sanborn, Managing Editor

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Davenport, Iowa's Genesis Medical Center will pay $1.88 million to settle allegations it violated the False Claims Act for keeping Medicare overpayments, the Department of Justice announced.

Court documents show that the government claimed that Genesis violated the False Claims Act for roughly three years, from January 2013 to December 2016, by keeping Medicare overpayments for certain hospital inpatient admissions of Medicare beneficiaries "when those admissions were medically unnecessary and should have been billed at the lower reimbursement rate for outpatient or observation services." 

"This recovery sends the message to healthcare providers there will be consequences if they fail to comply with state and federal regulations. We also note and appreciate the hospital's cooperation throughout the investigation,"  said Marc Krickbaum, United States Attorney for the Southern District of Iowa. 

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Vice President of Legal Affairs for Genesis Health System Paul Bollinger said they chose to resolve the matter to avoid costly and protracted litigation, but the settlement is not an admission of error.

"Genesis was not cited for deficiencies regarding patient care.  Genesis patient outcomes and patient safety continue to be outstanding. Interpretation of rules about billing classifications are complex. The inpatient admissions in question comprise less than 1 percent of total admissions over the period. Genesis remains steadfast and committed to our mission of providing compassionate, quality health services to all those in need," Bollinger said.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com