Jackson-Madison County General Hospital and Milan General Hospital have agreed to pay a substantial settlement to resolve allegations that the two facilities made false claims for payment from Medicare. The government alleged that from 1997 to 2002, Jackson-Madison General made claims to Medicare for transporting non-emergency patients that failed to satisfy Medicare’s requirements for medical necessity and documentation. From 1999 to 2003, Milan General is alleged to have improperly admitted Medicare patients into the hospital’s psychiatric unit. In addition, the hospital made claims to Medicare for patients who stayed in the hospital longer than permitted under Medicare coverage criteria. According to the U.S. Justice Department, both hospitals violated the False Claims Act by submitting the claims. As part of the settlement, the Jackson-Madison County General Hospital district will submit to oversight under a Corporate Integrity Agreement with the U.S. Department of Health and Human Services.

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