Anne Arundel Medical Center, Medicare Fraud, Maryland 2007

Baltimore, Maryland – Anne Arundel Medical Center (“AAMC”), located in Annapolis, Maryland, has agreed to pay the United States $3,154,000 to settle allegations under the False Claims Act that it submitted false claims to Medicare for services that were not medically necessary.

The settlement agreement was announced today by United States Attorney for the District of Maryland Robert K. Hur; Special Agent in Charge of the Office of Inspector General for the Department of Health and Human Services, Maureen Dixon; Norbert E. Vint, Acting Inspector General of the U.S. Office of Personnel Management; and Robert E. Craig, Jr., Special Agent in Charge for the Defense Criminal Investigative Services, Mid-Atlantic Division.

“Companies that submit false bills to the government must be held accountable. The United States Attorney’s Office is committed to taking the steps necessary to protect Medicare and other federal healthcare programs from fraud and abuse and recover taxpayers’ money,” said U.S. Attorney Robert K. Hur.

In or about June 2007, AAMC opened its Anticoagulation Clinic (“the Clinic”) to monitor outpatient’s anticoagulation therapy. Patients who take Coumadin or the generic equivalent have their blood routinely tested to monitor their clotting times. These tests are known as prothrombin time international normalized ration (PT-INR) tests.

The United States alleged that for the time period before January 1, 2014, a substantial percentage of the claims for CPT 99211 submitted by AAMC were not medically reasonable and necessary when submitted with CPT 85610. Further, the United States alleged that after January 1, 2014, all claims submitted by AAMC for CPT 85610 represented false claims when submitted with G0463.

The claims resolved by this settlement are allegations. The settlement is not an admission of liability by AAMC, nor a concession by the United States that its claims are not well founded.

Contemporaneously with the civil settlement, AAMC entered into a five-year Corporate Integrity Agreement (CIA) with the HHS-OIG which requires, among other things, the implementation of a risk assessment and internal review process designed to identify and address evolving compliance risks on an ongoing basis. The CIA requires training, auditing, and monitoring designed to address the conduct at issue in the case.

The settlement resolves a lawsuit brought by Barbara McHenry, a former AAMC employee, under the qui tam, or whistleblower, provisions of the False Claims Act, captioned United States, et al. ex rel. McHenry v. Anne Arundel Medical Center, Case No. ELH-15-1256. As part of the settlement, the whistleblower will receive $473,100.

The Maryland United States Attorney’s Office’s action in this matter.

Source: https://www.justice.gov/usao-md/pr/anne-arundel-medical-center-pay-more-3-million-settle-federal-false-claims-act