Blue Cross Blue Shield of Tennessee will pay $2.1 million to the United States to settle allegations over Medicare charges in New Jersey.
BCBST, which is headquartered in Chattanooga, Tenn., operates as Riverbend Government Benefit Administrators and serves as a Part A intermediary under the Medicare program.
The suit resulted from charges that BCBST, between 2000 and 2002, violated the False Claims Act by failing to adjust the cost-to-charge ratios for many New Jersey hospitals in a timely manner, resulting in the payment of excessive "outlier payments" by the Medicare program.
"Today's settlement demonstrates that the Justice Department will be vigilant in protecting the Medicare program from all who abuse it, including contractors that falsely bill for crucial tasks that they do not perform," said Gregory G. Katsas, assistant attorney general of the Justice Department's Civil Division.
The settlement was the result of a coordinated effort among the Justice Department's Civil Division's Commercial Litigation Branch; the Affirmative Civil Enforcement Unit of the U.S. Attorney's Office for the District of New Jersey; the Department of Health and Human Services' Office of Inspector General and Office of Counsel to the Inspector General; the Centers for Medicare and Medicaid Services; and the FBI.
"The United States relies extensively upon trusted contractors to uphold the integrity of the Medicare system within New Jersey, and any abuse of that trust will be sharply addressed," said Christopher J. Christie, U.S. Attorney for the District of New Jersey.