Genesis must pay $1.88 million to settle Medicare over-payment allegations

DAVENPORT, Iowa – Genesis Medical Center owes the United States government nearly $2 million to resolve allegations it violated the False Claims Act and has agreed to pay the money it owes from improperly keeping Medicare over-payments between Jan. 1, 2013 and Dec. 31, 2016.

The settlement was announced in a release from the US Department of Justice on Tuesday, March 27.

According to the release, Genesis violated the False Claims Act by improperly retaining Medicare over-payments for hospital inpatient admission claims when those claims should have been billed at the lower reimbursement rate for either outpatient or observation services.

The False Claims Act claims resolved by this settlement are allegations only and there has been no determination of liability.

“The settlement is not an admission of error,” said Paul Bollinger, J.D., Genesis’ VP of legal affairs in a statement. “Genesis has cooperated fully and resolved the matter to avoid costly and protracted litigation.”

“Our office will aggressively use the False Claims Act to ensure all health care providers play by the same rules and taxpayers do not pay the bill for unnecessary services,” said Marc Krickbaum, United States Attorney for the Southern District of Iowa. “This recovery sends the message to health care providers there will be consequences if they fail to comply with state and federal regulations. We also note and appreciate the hospital’s cooperation throughout the investigation.”

The United States Attorney’s Office for the Southern District of Iowa, in conjunction with the United States Attorney’s Office for the Northern District of Iowa, initiated this case. False Claims Act cases can also be brought under the qui tam provisions of the Act, which encourage whistleblowers to bring suit on behalf of the United States and share in any recovery.