Bradley partner Jason Mehta was quoted in a Health Care Compliance Association newsletter discussing false claims allegations in a recently settled matter. In the case, the U.S. attorney’s office declined to intervene in the lawsuit, and the hospital corrected the modifier problem after the whistleblower separated from the hospital, explained Mehta.
During the government’s investigation, the hospital also voluntarily refunded the $438,673 “related to the potential misuse of modifiers,” said Mehta.
The hospital is “a hospital of last resort, with primarily a Medicaid population,” Mehta added. “I can tell you with confidence there was no suggestion anyone at [the hospital] orchestrated or acted intentionally to bill improperly.”
The original article, “Hospital Settles FCA Case Filed by CO Over Modifiers; Make Sure People ‘Feel Heard’” appeared in the Health Care Compliance Association newsletter on September 13, 2021.