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Shands HealthCare to Pay $26M to Settle False Claims Allegations

John Commins, for HealthLeaders Media, August 20, 2013

Federal prosecutors say improper Medicare billing at six Florida hospitals operated by Shands ran from 2003 through 2008. Shands makes no admission of liability, but will pay a total of approximately $26 million plus interest.

Shands HealthCare will pay $26 million to settle whistleblower allegations that six of its Florida hospitals knowingly billed the government for inpatient procedures that should have been outpatient services, federal prosecutors said Monday.

"The Department of Justice is committed to ensuring that Medicare funds are expended appropriately, based on the medical needs of patients rather than the desire of healthcare providers to maximize profits," Stuart F. Delery, assistant attorney general for the Department of Justice's Civil Division, said in prepared remarks. "Hospitals participating in Medicare must bill for their services accurately and honestly."

The six Florida hospitals were named as defendants in a whistleblower lawsuit brought under the False Claims Act. Prosecutors said an audit showed that the improper billing at the six hospitals ran from 2003 through 2008 and that Shands officials knowingly submitted the improper claims to Medicare, Medicaid, and TRICARE.

The six Florida hospitals are: Shands at Jacksonville; Shands at Gainesville, also known as Shands at the University of Florida; Shands Alachua General Hospital; Shands at Lakeshore; Shands Starke and Shands Live Oak. Specifics details of the billing scheme were not provided in a media release issued by prosecutors.

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