Dive Brief:
- Children's National Medical Center, also known as Children's National Health System, is set to pay $12.9 million to resolve allegations that the hospital system violated the False Claims Act.
- CNMC is alleged to have submitted false cost reports and other materials to HHS and the District of Columbia Medicaid program.
- The incorrect information was then used by HHS and Medicaid programs to determine reimbursement rates for CNMC, resulting in overpayment.
Dive Insight:
The allegations against CNMC come from a lawsuit filed by a former employee under the whistleblower provisions of the False Claims Act. The whistleblower will recieve $1,890,649.48 for his role.
Through the settlement, the claims remain allegations with no determination of liability.
"This settlement demonstrates our commitment to defending the integrity of the system and ensuring that taxpayer money goes to meet the most critical healthcare needs," sais Acting U.S. Attorney Vincent H. Cohen Jr. of the District of Columbia in a prepared statement. "We will continue to work with whistleblowers like the former employee who came forward in this case to battle waste, fraud and abuse that fuel the skyrocketing cost of healthcare."