New Jersey Hospital Settles Fraud Allegations for $6.35 Million

The respected Robert Wood Johnson University Hospital is set to pay over $6 million in order to settle allegations of Medicare fraud.

Two federal lawsuits brought against the hospital claim that bills to the hospital’s Medicare patients were fraudulently inflated in order to gain larger payments from the Medicare program. The federal program supplies supplemental reimbursements, known as “outlier payments,” to health care institutions when the cost of care is unusually high. Robert Wood Johnson University Hospital is accused of inflating costs in order to gain access to these outlier payments, which were created as a protection to health care providers who might be giving care to patients with extraordinary conditions.

Both federal lawsuits were brought under Qui Tam provisions of the False Claims Act. The whistle blowers will receive just over $1.1 million in compensation for reporting the alleged fraud.

To date, with the help of whistle blowers, the Justice Department has been able to regain nearly $1.1 billion in outlier payment fraud.

Posted in Health Care Fraud, Medical Billing Fraud, Medicare Fraud, Medicare WhistleblowerNo Comments

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