OKLAHOMA CITY – Oklahoma Heart Hospital South has paid more than $1 million to settle civil claims stemming from allegations it submitted false claims to Medicare.
OHHS is an Oklahoma limited liability company that owns and operates the Oklahoma Heart Hospital South, which is an acute care hospital located in Oklahoma City.
After an internal review and audit, OHHS discovered irregularities regarding its billing of certain services, and proactively contacted the United States to self-disclose the issues. The federal government investigated the disclosures and issues raised by hospital.
Throughout the investigation, and to its credit, OHHS cooperated with the United States Attorney’s Office and the U.S. Department of Health and Human Services Office of Inspector General in the investigation, U.S. Attorney Robert J. Troester said.
The voluntary disclosure and investigation revealed that from June 1, 2013, through May 31, 2019, OHHS submitted claims to Medicare for Intensive Cardiac Rehabilitation services provided to Medicare beneficiaries.
Before billing Medicare for these services, OHHS was required to have a physician complete and sign an individualized treatment plan for the patient. If the patient was going to receive ICR for longer than 30 days, a physician must complete and sign updates to the treatment plan every 30 days afterward.
The government alleged that claims for ICR services submitted by OHHS to Medicare for payment violated the False Claims Act because a physician did not complete and/or sign individual treatment plans and/or ITP updates for certain Medicare beneficiaries.
To resolve the claims, Oklahoma Heart Hospital South agreed to pay $1,151,770 to the United States. In reaching this settlement, OHHS did not admit liability and the government did not make any concessions about the legitimacy of the claims.
The agreement allows the parties to avoid the delay, expense, inconvenience, and uncertainty involved in litigating the case, Troester said.