Brattleboro Memorial Hospital settles false claims allegation

This article by Bob Audette originally appeared Feb. 26 in the Brattleboro Reformer.

BRATTLEBORO — Brattleboro Memorial Hospital paid $1,655,000 to the United States and the state of Vermont to resolve civil claims that it “knowingly” presented or caused to be presented “false claims for payment to Medicare and Medicaid.”

According to the U.S. Attorney’s Office for the District of Vermont, from approximately January 2012 through September 2014, “BMH knowingly submitted or caused to be submitted a number of outpatient laboratory claims lacking documentation necessary to support reimbursement by Medicare and Medicaid.” Doing so was a violation of the federal False Claims Act and the Vermont False Claims Act, stated a press release issued Monday afternoon.

The $1,655,000 will be divided between the federal Medicare, federal Medicaid, and Vermont Medicaid programs to which BMH submitted the alleged false claims.

“Pursuant to the settlement agreement, the settlement and payment are neither an admission of liability by BMH, nor a concession by the United States or State of Vermont that their claims are not well founded,” stated the press release.

According to the press release, Amy Beth Main filed a complaint against BMH under the qui tam provisions of the federal False Claims Act. Qui tam lawsuits are a type of whistleblower lawsuit that rewards whistleblowers in successful cases where the government recovers funds lost to fraud.

Read full story at the Brattleboro Reformer.

(Fair use with written permission from the New England Newspapers Inc.)

Image courtesy of Wikimedia Commons/John Phelan

2 thoughts on “Brattleboro Memorial Hospital settles false claims allegation

  1. My Medicare and Medicaid payments came out of my pocket. Why doesn’t the “payback” go to the insurance payers instead of the state and Feds? BMH bogus billings in reality went against the client. It was greed, and they thought they could get away with it.

    How many clients can decipher the billing codes, or care, or inform, or confront, or challenge? The medical billing system is against the patent.

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