Yale New Haven Health and Northeast Medical Group, an organization affiliated with the health care system, have agreed to pay more than $500,000 after over-billing for services over a six-year period, officials said Tuesday.
The settlement resolves allegations that medical providers at Bridgeport Hospital submitted false claims to Medicare and Medicaid for six years, officials said.
The U.S. Attorney's Office said the services "did not satisfy certain billing requirements" and should have been been billed by "mid-level providers."
"As a result, Yale and Northeast Medical improperly received 10 to 15 percent higher in Medicare and Medicaid reimbursements for the allegedly falsely billed hospitalist physician services," the office said in a news release Tuesday.
Attorney General William Tong's office said the joint federal and state investigation was prompted by a whistleblower's lawsuit that alleged the two organizations improperly billed the federal Medicare and the state Medicaid programs for services that were provided by higher-level medical providers at Bridgeport Hospital. But in fact, those services were provided "only by mid-level providers," Tong's office said Tuesday, meaning they were supposed to be reimbursed at lower rates.
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