tci Part B Insider - 2010 Issue 7

FRAUD AND ABUSE: Ignore Internal Audit Findings At Your Own Risk

Sweeping dirt under the rug could be costly. A recent whistleblower lawsuit at a health system points to mistakes you should be avoiding in your organization. Genesys Health System recently paid nearly $670,000 to settle a False Claims Act lawsuit initiated by an internal auditor, who blew the whistle on alleged upcoding of physician services. What happened: The government alleges that the multi-facility organization overbilled Medicare from 2001 to 2007 for evaluation and management services rendered to cardiology patients, according to a Department of Justice release. The whistleblower in the case received a $133,882 share of the...

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