CORAL GABLES, Fla. – The University of Miami will pay $22 million to settle claims involving medically unnecessary laboratory tests and fraudulent billing practices.
The school violated the False Claims Act by ordering the unnecessary lab tests and submitting false claims through its laboratory and off campus hospital-based facilities, according to the Department of Justice.
Some of the unnecessary tests were for patients who received kidney transplants.
“Medical providers who submit fraudulent claims to our taxpayer-funded health care programs not only violate the public’s trust, they compromise the very integrity of these programs,” said Acting U.S. Attorney Juan Antonio Gonzalez for the Southern District of Florida. “Our office will aggressively pursue investigations against all providers who knowingly violate these billing rules no matter their size.”
“Health care providers who charge for medically unnecessary services and knowingly violate billing rules contribute to the soaring cost of health care,” said Acting Assistant Attorney General Brian M. Boynton for the Justice Department’s Civil Division. “The department will investigate and hold accountable those who seek to profit at the expense of federal health care programs and their beneficiaries.”
“Bilking the Medicare program and patients by charging for medically unnecessary services will always draw the attention of my office,” said Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Working with our law enforcement partners, our agents are committed to investigating alleged billing scams that result in tremendous costs to federal health care programs and its beneficiaries.”
According to the DOJ, the civil settlement resolves allegations made in three lawsuits. Those suits were filed under the whistleblower provisions of the False Claims Act, which permit private individuals to sue on behalf of the government for false claims, and to share in any recovery.