UCHealth, the state’s largest medical provider, has reached a $23 million settlement with federal authorities over allegations that it overbilled for emergency care at its hospitals, the Colorado U.S. Attorney’s Office announced Tuesday.
The allegations claim that UCHealth hospitals from Nov. 1, 2017, through March 31, 2021, automatically used the most expensive billing code possible for certain emergency department claims submitted to government health coverage programs Medicare and TRICARE, which is for members of the U.S. military and retirees.
Using this billing code without having proper justification violates the Fair Claims Act, the feds allege.
“Improperly billing federal health care programs drains valuable government resources needed to provide medical care to millions of Americans,” Principal Deputy Assistant Attorney General Brian M. Boynton, the head of the Justice Department’s Civil Division, said in a statement. “We will pursue health care providers that defraud the taxpayers by knowingly submitting inflated or unsupported claims.”
UCHealth denied wrongdoing.
“UCHealth is pleased to see the end of this lengthy and resource-intensive investigation,” UCHealth spokesman Dan Weaver said in a statement. “UCHealth denies these allegations, but we agreed to the settlement to avoid potentially lengthy and costly litigation. The settlement allows us to focus our resources on providing excellent patient care.”
The complex world of hospital billing
The allegations...
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