Boston Medical Centre (BMC) and two physician practice organizations working under it were spotted for medical billing fraud allegations. According to the reports, they have now agreed to pay a sum of $1.1 million as compensation.
Responding to the news, an official said that issues like abuse and waste in Medicare and Medicaid and medical billing fraud are the most incurable ‘diseases’ that the healthcare industry needs to work on at the moment. The funds allocated for rectifying these issues could have been given out to the vulnerable populations, had these issues never occurred. Due to the surge in the number of these types of issues, many hospitals and clinics are charged with billing fraud cases. In this process, they end up giving away millions of dollars to settle these allegations.
As per the reports, the Boston Medical Centre will be charged $1.1 million towards the settlement of these allegations of medical billing fraud. The allegations underline that BMC had committed serious faults with regard to Medicare and Medicaid billing. The major accusation charged against BMC is that it billed Medicare for more units of Rituxan, a costly cancer drug. In fact, it had used quite less than what it charged Medicare for. Reports add that the BMC management has agreed to pay the said penalty.
There is also allegation that the hospital made unreasonable number of claims to Medicare in respect to the cost of outpatient podiatry services. Meanwhile, the clinical documentations regarding these charges did not reasonably reflect the needs for these services. Another allegation levelled against BMC is that it billed Medicare and Medicaid for the services offered at its pre-surgical treatment centre. Reports reveal that BMC had already availed a global fee for these services.
A spokesperson from the Office of Inspector General of the HHS said that making false claims would mean that the accused party would end up paying fines of up to three times the actual cost of program in addition to $11,000 per claim made.
Meanwhile, a representative from BMC said that it was ready to co-operate with the concerned authorities in resolving these allegations. He added that the hospital has contacted HHS and the Department of Justice and agreed to work with them in resolving the issues. The hospital is open to any type of investigations. The allegations with regard to the improper use of funds have already been fixed after the primary investigation report was released.