Geisinger to pay $18 million after violating Medicare rules

Regional News

HARRISBURG, Pa. (WTAJ) — Geisinger Community Health Services has agreed to pay over $18 million in civil litigation after the organization found it had violated Medicare rules and regulations.

The United States Attorney’s Office for the Middle District of Pennsylvania announced the settlement Monday after affiliated entities of Geisinger voluntarily disclosed the violations to take corrective action. Geisinger had reportedly submitted claims to Medicare for hospice and home health services between January 2012 and December 2017.

This was a violation of Medicare rules and regulations regarding physician certifications of terminal illness, patient elections of hospice care, and physician face-to-face encounters with home health patients, according to Acting United States Attorney Bruce D. Brandler.

“The $18 million payment in this matter reflects the priority healthcare providers should place on making sure they closely follow all Medicare rules and regulations,” Attorney Brandler said. “Healthcare fraud remains a focus of the Department of Justice and the Affirmative Civil Enforcement Unit of the United States Attorney’s Office. I commend GCHS for taking this seriously, voluntarily disclosing these issues to our office and working to address the problems that led to these violations.”

The settlement was handled by the Department of Health and Human Services, Office of Counsel to the Inspector General, the Justice Department`s Civil Division Commercial Litigation Branch, Fraud Section, and AUSA Tamara Haken of the Affirmative Civil Enforcement Unit of the U.S. Attorney`s Office for the Middle District of Pennsylvania.

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