Christus Spohn Health System Corporation has agreed to pay the federal government over $5 million to settle claims that the company violated sections of the False Claims Act. Among other charges, the company is accused of admitting people as inpatients when they were receiving outpatient procedures, resulting in higher fees being paid to the healthcare provider.
Six different Christus Spohn facilities in and around Corpus Christi, TX were involved in the allegations. Charges brought by federal investigators claimed that the company submitted false Medicare claims by billing for cheaper outpatient procedures using more expensive inpatient codes. The investigation began in March 2008 when Christus' former director of case management filed a whistleblower suit against the company claiming that their fraudulent actions greatly increased the revenue the company received from Medicare payments. Under the qui tam provisions of the federal false claims act, the whistleblower is likely to receive 20% of the $5,100,481 settlement.
When announcing the settlement on June 21, U.S. Attorney Kenneth Magidson said it "once again demonstrates (the government's) commitment against fraud and abuse that threatens the financial health of our federal healthcare programs." The medical injury attorneys at Arnold & Itkin support the fraud crackdowns being conducted by the U.S. Attorney's Office and hope that the government continues to hold fraudulent companies accountable for their actions. We strongly believe that when health care companies put more emphasis on profit earning than on patient safety, they deserve to be punished for their unethical behavior.