The Richmond-based health system says it discovered the overcharges during an audit of patient files, notified federal officials, and helped with the investigation.
Virginia Commonwealth University Health System Authority will pay the federal government and Virginia $4.6 million to settle self-disclosed overbillings to government health plans for radiation oncology services, the Department of Justice announced.
Richmond-based VCU discovered the overbillings to Medicare, Tricare, and the Federal Employees Health Benefits Plan, which had occurred from 2009 through 2014, while auditing patient files and claims data, took corrective action, notified federal regulators, and helped investigators, DOJ said.
VCU Medical Center issued this statement on the overbilling:
"During a 2013 internal compliance review, VCU Health System identified possible concerns with its Department of Radiation Oncology billing and documentation."
"This prompted VCU Health System to have an extensive external review conducted. The external review identified inaccurate payments from governmental payers, which VCU Health System voluntarily self-reported. There was no evidence of fraudulent activities discovered."
"VCU Health System agreed to repay roughly $4 million to the federal government to resolve the inaccurate payments, and has taken corrective action to address its radiation oncology billing practices. In addition, the review indicated approximately $640,000 in inaccurate payments that will be repaid to the Commonwealth."
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
The self-disclosed overbillings were for radiation oncology services.
VCU says it has taken corrective action to address faulty billing practices.