The Medical Center of Central Georgia, False Claims Act, Georgia 2023
The Medical Center of Central Georgia, a hospital in Macon, Georgia, has agreed to pay $20 million to settle allegations that it violated the False Claims Act by billing Medicare for more expensive inpatient services that should have been billed as less costly outpatient or observation services, the Justice Department announced today.
The hospital, which is the second largest in the state, allegedly violated the False Claims Act by knowingly charging Medicare for medically unnecessary inpatient admissions from 2004 through 2008.
“Charging the government for higher cost inpatient services when the patient care received was outpatient or observation services causes Medicare to pay more than it should,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department’s Civil Division.
The hospital's alleged overcharging resulted in substantial financial harm to Medicare, as hospitals generally receive significantly higher payments from Medicare for inpatient admissions as opposed to outpatient or observation services.
“Overcharging the government for medical services wastes our country’s limited health care resources,” said Acting U.S. Attorney John Horn of the Northern District of Georgia.
As part of the settlement, The Medical Center of Central Georgia entered into a corporate integrity agreement with the U.S. Department of Health and Human Services – Office of Inspector General that requires the company to engage in significant compliance efforts over the next five years.
Defendant: The Medical Center of Central Georgia
Crime: Violating the False Claims Act by billing Medicare for more expensive inpatient services that should have been billed as less costly outpatient or observation services
City and State: Macon, Georgia
Exact Date: Allegations occurred from 2004 through 2008
Sentence or Outcome: The hospital agreed to pay $20 million to settle the allegations
Dollar Amounts: $20 million settlement
Key Facts
- State: Georgia
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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