Southern Crescent Hospital, a long-term acute care hospital in Riverdale, Georgia, and its manager, the Dubuis Health System, have agreed to settle allegations that they violated the False Claims Act. The Justice Department announced that the pair will pay the United States $8,000,000 to resolve claims that they knowingly overcharged Medicare.
Long-term acute care hospitals are similar to typical acute care hospitals, but they specialize in treating patients with more complex medical needs whose hospital stays generally exceed 25 days. Long-term acute care hospitals receive a higher reimbursement rate from Medicare than standard hospitals.
In 2009, Darlene Tucker, a former administrator for Southern Crescent, filed a whistleblower lawsuit under the qui tam provisions of the False Claims Act in the Southern District of Texas. Ms. Tucker alleged that Southern Crescent and Dubuis Health System knowingly kept Medicare patients hospitalized beyond what was medically necessary in order to increase the Medicare reimbursement. The whistleblower alleged that Southern Crescent and Dubuis Health System submitted false claims for these extended hospital stays to Medicare between 2003 and 2009.
As her reward under the qui tam provisions of the False Claims Act, Ms. Tucker will receive $2,160,000 of the settlement proceeds.