Community Health Systems will pay $97,257,000.00 to settle whistleblower lawsuits unsealed in federal courts across the country.
Federal officials alleged CHS routinely admitted Medicare patients who presented at their hospitals’ emergency rooms with conditions that did not require admissions so that it could bill Medicare at higher inpatient rates, rather than less expensive outpatient rates.
To drive these valuable inpatient admissions, CHS established benchmarks for the percentage of patients, particularly those over 65, who should be admitted from the emergency room, in a scheme intended to improve its profitability, and without regard to medical necessity or patient safety.
How did these creeps make employees cooperate with their fraud?
CHS enforced those benchmarks by incentivizing and pressuring emergency department physicians and administrators to meet them. Physicians and administrators who failed to meet CHS’s benchmarks were threatened with termination, and some in fact were fired.
Seven separate whistleblower lawsuits filed against CHS…
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