- The Department of Justice announced Tuesday that Indianapolis-based Community Health Network will pay $20 million to address allegations that it overbilled for outpatient surgeries.
- According to the settlement, Community billed for services performed at Community facilities as if they had been performed off-site in order to acquire the higher Medicare rates.
- Community does not deny the allegations but instead claims that it sought federal guidance on its billing practices during the period under scrutiny—and were not informed that their billing policies were inappropriate.
"We're very disappointed with the federal government's characterization of this issue," said Community CEO Bryan Mils in a statement. "At most, this was an innocent and unintentional billing error. In fact, we continually reached out for guidance to assure our billing method was appropriate."
That may in fact be true since Community got off light here—according to Mills, that $20 million is the exact amount the feds claim the provider overbilled and does not include any penalties. Under the False Claims Act, providers can be penalized for as much as three times the amount overbilled, plus a fine of $5,500 to $11,000 for each false bill submitted. It seems like the DOJ is just recouping a federal loss here, although Community has now entered into a corporate integrity agreement with HHS.
Community operates eight hospitals in three cities in Indiana, as well as over 200 sites of care in those cities.