GIBSON CITY, Ill. (WAND) - A local hospital will pay about $292,000 to resolve allegations claiming it failed to return overpayments it received.
Prosecutors said Gibson Area Hospital in Gibson City took in these overpayments between March 9, 2014 and March 24, 2020 from Medicare, Medicaid and other government programs. The hospital was accused of violating the False Claims Act by failing to return the money.
The hospital was accused of knowingly retaining the overpayments pursuant to alleged practices of keeping overpayments that were under $10, were over one year old, were duplicate payments, were improperly applied toward separate claims, and/or were payments for which the payer had not requested a refund three times.
The United States will receive about $208,000 in the settlement, while the State of Illinois will take in about $84,000.
“This settlement, which avoids protracted litigation, demonstrates that the United States Attorney’s Office, in conjunction with its partners, remains committed to protecting Medicare and Medicaid,” said Acting U.S. Attorney for the Central District of Illinois Douglas J. Quivey. “Although complex programs, the fact remains all medical providers must follow the rules and return taxpayer dollars to which they are not entitled.”
“Hospitals and other health care entities must follow agreed upon policies and guidelines while doing business with the Federal government,” said Special Agent in Charge Curt L. Muller of the U.S. Department of Health and Human Services, Office of Inspector General. “Those engaging in improper billing practices can expect that HHS-OIG and its partners will work to recover inappropriately handled funds.”
Prosecutors noted claims resolved by the settlement are only allegations, and there has not been any determination of liability.
The settlement was the result of a coordinated effort by the U.S. Attorney's Office for the Central District of Illinois, the Inspector General's Office of the Department of Health and Human Services, and the Illinois State Police Medicaid Fraud Control Unit.
