Hawaii’s largest private hospital resolves False Claims Act suits

Hawaii’s Queen’s Medical Center has settled two major lawsuits charging the hospital with overcharging Medicare, Hawaii’s Medicaid program and the TRICARE medical program for military dependents. The Queen’s Health Systems, which operates Hawaii’s largest private hospital, denied wrongdoing and claimed that the hospital settled the lawsuits merely to avoid the outlay of further legal costs.

The lawsuits were originally filed in state and federal court by two former pharmacy technicians who alleged that the hospital presented false statements for drugs and also billed federal programs for medical services rendered with insufficient supervision under federal rules. According to the lawsuit, from September of 1999 through October of 2002, the hospital made false claims to Medicare, Medicaid and TRICARE for payment in connection with anti-psychotic medications that were supposed to have been prescribed by a psychiatrist. But the government alleged that the medications were prescribed by doctors without the prior knowledge of a psychiatrist.
In addition, the government charged that from July of 1999 through June of 2006, Queen’s Medical Center submitted claims for payment to Medicare, Medicaid and TRICARE for care ostensibly provided by teaching physicians, though the hospital lacked sufficient proof under federal program guidelines to show that the services had been performed by physicians rather than unsupervised medical residents.

Under the False Claims Act, the two whistleblowers will receive a significant share of the government’s settlement.

Read the AP story at Google News.