The University of Medicine and Dentistry of New Jersey will pay $2 million to resolve federal allegations that its hospital defrauded Medicaid, according to the Justice Department.
According to federal investigators, from 1993 to 2004, UMDNJ’s University Hospital submitted claims to Medicaid for outpatient physician services that were also being billed by doctors working in the hospital’s outpatient centers. By submitting duplicate claims for payment, they said, the hospital doubled-billed the Medicaid program.
"Today’s settlement demonstrates that the Department of Justice will not tolerate fraud on our Medicaid programs, which were created to serve our nation’s low-income families, children and seniors," said Tony West, Assistant Attorney General for the Justice Department’s Civil Division.
The case against UMDNJ and University Hospital originated in a whistleblower complaint filed under the Federal False Claims Act by Dr. Steven Simring. In late 2005, the double billing addressed by the settlement was also the subject of a criminal complaint filed against UMDNJ by the U.S. Attorney’s Office for the District of New Jersey.
As a result of a deferred prosecution agreement concerning that criminal complaint, the state of New Jersey previously recovered $4.9 million from University Hospital, half of which was to be returned to the federal Medicaid program.
Under the terms of the agreement, UMDNJ will pay an additional $2 million to the federal government to resolve the outstanding civil federal false claims act allegations. The total federal recovery when combined with the previous payment is $4.45 million. Simring will receive $801,000 as his share of the total federal recovery.