Delaware hospital agrees to $4 million Medicare fraud settlement

(ShutterStock)
St. Francis hospital in Wilmington discovers and admits to improper Medicare and Medicaid billing.
St. Francis Hospital discovered that patients were admitted to the inpatient rehabilitation unit between 2007 and 2010 for treatment that was not medically necessary or the treatment would not qualify for reimbursement.
The hospital took action to correct the payments and voluntarily disclosed the issues to the US Attorney’s Office and the Office of the Inspector General of the Department of Health and Human Services. Otherwise, the fraud would have only been uncovered through a whistleblower report or a DHSS investigation.
Charles M. Oberly, III, United States Attorney for the District of Delaware, applauded St. Francis Hospital for admitting fault, “The government was able to recover monetary damages for compliance issues that might not have been revealed without St. Francis’ self-disclosure, and St. Francis can move forward without concern about lingering liabilities related to this conduct.”
Under the False Claims Act, St. Francis has agreed to pay $4,081,816.00 to the United States and $199,894.00 to the State of Delaware to resolve the matter.
WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.