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Johns Hopkins Bayview Medical Center Inc. has consented to pay a sizable amount to settle charges that the hospital violated the False Claims Act by submitting false claims to various health benefits programs. From 2005 to 2007, alleged the government, Bayview hospital employees claimed to have treated patients for conditions from which they did not suffer, including acute respiratory failure and malnutrition. By increasing the severity of Bayview’s mix of medical conditions to be treated, the hospital was able to maximize the rates at which it received reimbursement from the Maryland Health Services Cost Review Commission.
The fraudulent conduct was uncovered after two hospital employees filed a lawsuit under the federal False Claims Act. The whistleblowers alleged that Bayview employees would review inpatient charts to determine whether the severity of patients’ complaints could be exaggerated or falsified with lab test results to suggest the existence of additional medical conditions. The employees then advised hospital physicians to include the erroneous diagnoses in patients’ medical records.
For the full story, go to the Baltimore Sun.