American Academy of Emergency Medicine

Columbia/HCA Agrees To Pay $745 Million in Civil Claims

Columbia/HCA Healthcare Corp. announced it will pay $745 million in civil claims in a partial settlement of a Medicare fraud case. The Department of Justice has been investigating Medicare fraud issues relating to Columbia's diagnosis related group (DRG) coding, outpatient laboratory billing, and home health, Columbia/HCA said. Aside from saying it will pay the $745 million, the company also said it reached an agreement with the Department of Health and Human Services' Office of Inspector General on the terms of a corporate integrity agreement assuring the government of Columbia's overall Medicare compliance with regard to DRG coding, outpatient billing, and two civil issues still to be resolved-physician relations and cost reports. The agreement is subject to the approval by other officials in the DOJ, to execution of a number of agreements and documents, and to court approval. DOJ's statement on the issue was relatively mute, saying it had reached a tentative agreement with Columbia that, "if formally approved by the Department, would resolve a number of issues under investigation." Columbia said it expects the terms of its deal will result in an after-tax charge of about $498 million to be recorded in the financial statement for the quarter ending June 30.

Source: AHA News Now, May 18, 2000