January 15, 2003 Maury Regional Hospital
Maury Regional Hospital has agreed to pay $2 Million Dollars to settle claims asserted in a qui tam action filed by Ed Taylor, one of its former employees. The allegations in the complaint were that the hospital had violated the False Claims Act by “upcoding” diagnosis codes. Upcoding is the practice of assigning diagnosis codes which are not supported by the physicians documentation in the medical record on the claim. Upcoding can be used to charge the government for a more expensive procedure or service than the one which was actually performed or provided, resulting in the government paying the medical provider more than they are legally entitled to receive.
As part of the settlement, Mr. Taylor will receive $350,000 for having filed the qui tam action.
See U.S. Dept of Justice Press Release 1/15/03