WUFT News

UF Health Pays Millions To Federal Government

By on August 20th, 2013

UF Health/Shands Hospital has agreed to pay $26,000,000 to resolve allegations made under the False Claims Act that billing processes at the Shands network of hospitals resulted in overpayments by Medicare and Medicaid.

The settlement results from a whistleblower lawsuit filed in the Middle District of Florida in 2008, and was just made public this week. The whistleblower had been hired as an independent consultant by Shands in 2006 and 2007 to conduct a routine audit of billing practices. The audit showed inconsistent billing processes in 2006 and 2007. For some patients, Shands may have billed Medicare and Medicaid for short overnight inpatient admissions rather than for less expensive outpatient or observation services. In each case of alleged overbillings, the patient received all services ordered.

“We hold ourselves accountable for the highest standards of care and service. The case in question does not involve the failure to provide high-quality patient care, but rather inconsistent billing processes,” said Timothy M. Goldfarb, CEO of Shands HealthCare in Gainesville. “We proactively initiated an independent audit that identified some opportunities to improve billing processes at Shands. We took immediate steps to make improvements.”

Shands officials fully cooperated with the state and federal investigation and negotiated the settlement agreement announced Monday to avoid long and costly litigation. While there has been no admission of liability, Shands HealthCare hospitals in Gainesville and Jacksonville will pay a total of approximately $26,000,000 plus interest: $25.2 million to the United States under the Medicare program and $829,600 to the State of Florida under its Medicaid program.
ufhealth
Changes made to Shands’ processes and procedures have included:
• Improvements to case management protocols and utilization review processes with an improved team approach to accurately assess and code the care provided
• The use of improved software
• Implementation of new policies and procedures
• Supplemental employee training
• The engagement of expert physician advisors who help assess coding and are on staff 24/7

“As a responsible corporate citizen, our intent and practice has always been to comply with government regulations. We have conscientiously worked to create and operate an appropriate, fair and accurate billing system for all payers,” Goldfarb added. “There was no intentional misconduct or callous disregard of these issues on our part.”

——————————————


This entry was posted in Health and Science and tagged , , . Bookmark the permalink.
 

More Stories in Health and Science

By leppyone (Nine-banded Armadillo) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

Armadillos May Be Cause for Rising Leprosy Rates in Florida

Florida health officials are warning people to stay away from armadillos as they may be the cause of recent leprosy cases in the state. There have been nine cases reported in the last seven months, but none have been reported in Alachua.


Breastfeeding

Florida Hospitals Promote Breastfeeding

Hospitals around Florida are working to create initiatives to help mothers and future mothers with breastfeeding.The Florida Health Department connected with hospitals in 15 counties in June to participate in the Healthiest Weight Florida’s Baby Steps to Baby Friendly Initiative.


Tatum bicycles on the Hawthorne Trail with a group of 30 people from Gator Cycle and Body By Boris. Nicole Aedo / WUFT News

Former Addict Finds Purpose In Biking

Andrew Tatum battled multiple addictions with hard drugs and junk food. Now he finds peace and purpose in biking and blogging about his struggles in order to help others.


Nate Willingham focuses on matching three cards based on color, shape or pattern during his Brain Works session on Friday. This card game is used to improve visual perception.

Brain Training Center Treats Learning Disabilities

Brain Works in Gainesville uses auditory training to treat learning disabilities and brain trauma. It’s helped 13-year-old Nate with his dyslexia, dyscalculia and dysgraphia, but scientists question how effective the treatment really is.


UF Study Shows Grape Seed Oil Can Reduce Obesity

A new study has found that muscadine grape seed oil can help reduce obesity. Containing a vitamin E derivative, the oil can help prevent the formation of new fat cells.


Thank you for your support

WUFT depends on the support of our community — people like you — to help us continue to provide quality programming to North Central Florida.
Become a Sustainer
I want to support FM 89.1/NPR
I want to support Florida's 5/PBS
Donate a Vehicle
Underwriting Payments