DOJ reports University of Miami agrees to $22M settlement over FCA allegations -

The U.S. Department of Justice (DOJ) alleged the University of Miami engaged in three fraudulent practices under the False Claims Act:

..Knowingly engaging in improper billing relating to its hospital facilities. Medicare allows the conversion of physician offices into hospital facilities if they meet certain criteria. One of these requirements is notifying Medicare beneficiaries of the higher costs associated with receiving care in hospital facilities as opposed to physician offices. DOJ alleges this wasn’t done;

..Billing federal healthcare program for medically-unnecessary lab tests for kidney transplant patients from the university’s Miami Transplant Institute (MTI); and

..Causing Jackson Memorial Hospital (JMH) to submit inflated claims for reimbursement for pre-transplant lab tests conducted at the MTI in violation of related party regulations.

The University of Miami agreed to pay a $22-million settlement to resolve the allegations. In a separate agreement, JMH paid a $1.1-million settlement to the DOJ.