Trinitas Regional Medical Center in Elizabeth, N.J., has agreed to pay $3.02 million, plus interest, to settle Medicare fraud charges filed by the Justice Department.
Federal investigators are also seeking to intervene in a lawsuit brought against Brookhaven Memorial Hospital in East Patchogue, N.Y.
Both hospitals are defendants in a 2005 lawsuit brought by a whistleblower, Tony Kite, involving allegations that they inflated charges to Medicare patients to obtain enhanced reimbursement in Medicare "outlier payments.”
Enacted by Congress, the supplemental outlier payments system is designed to ensure that hospitals possess the incentive to treat patients whose care requires unusually high costs. According to the lawsuit, the hospitals inflated charges to obtain extra payments for cases that were not costly.
"The Department of Justice is committed to pursuing those who defraud Medicare and drive up the cost of healthcare," said Assistant Attorney General Tony West, head of the Justice Department’s Civil Division.
"This office is determined to protect the integrity of the Medicare system for the citizens of New Jersey and of the United States," said U.S. Attorney Paul J. Fishman.
Under the announced settlement, Kite will receive approximately $679,000, plus interest, from Trinitas Regional Medial Center.