California Hospital Pays $5.25 Million to Settle Outlier Billing Allegations

St. John’s Health Center, of Santa Monica, California, has agreed to pay the federal government $5.25 million to settle allegations that it sought inflated Medicare “outlier” payments. These payments are only intended for extraordinarily expensive medical care, and are not intended to reimburse the hospital for routine procedures. By allegedly turbo charging–raising its charges more quickly than its actual costs were rising–between 1996 and 2003, Saint John’s obtained significant amounts of Medicare outlier payments that it was not entitled to receive, according to the federal government. Several other hospitals have recently settled similar cases under the False Claims Act.

 For more information about qui tam law and Medicare fraud, contact Nolan and Auerbach, PA.