The U.S Attorney’s Office for the District of Connecticut announced on May 9 that Yale New Haven Health Services Corp. and Northeast Medical Group, Inc. have paid $560,718.48 to resolve federal and state False Claims Act (FCA) allegations. The hospital system allegedly submitted claims to Medicare and Medicaid for services provided by mid-level providers at Bridgeport Hospital as though they had been rendered by physicians.
The lawsuit, a qui tam action brought by a former employee of Northeast Medical, alleged that Yale and Northeast Medical submitted claims for evaluation and management services that did not satisfy the requirements to be billed under hospitalist physicians. The services should actually have been billed as having been rendered by advanced practice nurse practitioners and physician assistants.
The relator in the case, U.S. ex rel. Cadariu v. Northeast Medical Group et al., will receive $106,536.51 as her share of the recovery.
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