December 14, 2000 HCA
HCA-The Healthcare Company (formerly known as Columbia-HCA) has agreed to pay more than $840 Million Dollars to settle claims asserted in qui tam actions, which were filed under the False Claims Act. The allegations of the cases were that HCA billed Medicare, Medicaid, TRICARE (the Defense Department’s health care program), and FEHBP (the Federal Employee Health Benefits Program) for lab tests which were not medically necessary, and not ordered by physicians. Other allegations were that HCA engaged in “upcoding” where false diagnosis codes are assigned to patient records in order to increase the monies which the federal health insurance programs would pay to HCA, and that it billed Medicare for non-reimbursable costs, and devised an elaborate scheme to hide these costs in reimbursable “management fees” paid to third parties.
Individuals who filed qui tam cases may be awarded up to 30% of the monies recovered in their respective cases.
See U.S. Dept of Justice Press Release 12/14/00