FOR IMMEDIATE RELEASE
WEDNESDAY, JANUARY 7, 2009
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BOSTON MEDICAL CENTER AND EAST BOSTON NEIGHBORHOOD HEALTH CENTER PAY $600,000 TO SETTLE FALSE CLAIMS ALLEGATIONS
Boston, MA - United States Attorney Michael J. Sullivan and Massachusetts Attorney General Martha Coakley announced today that a Boston hospital and its community health center have paid $600,000 to settle allegations that they submitted inappropriate charges to the Massachusetts Uncompensated Care Pool for emergency services rendered at the Urgent Care Department of East Boston Neighborhood Health Center. In addition to payment of the settlement amount, and under the terms of the agreement, Boston Medical Center and East Boston Neighborhood Health Center have agreed to enter into discussions with the Department of Public Health regarding the standards for operation of the Urgent Care Department.
The Massachusetts Uncompensated Care Pool, now known as the Health Safety Net Trust Fund, and commonly referred to as the “free care pool” provides reimbursement to acute care hospitals and community health centers for medically necessary services provided to low-income, uninsured and underinsured residents of Massachusetts. The free care pool is funded in part by federal and state governments. East Boston Neighborhood Health Center and Boston Medical Center settled a civil lawsuit which alleged that they overcharged the government for services provided to patients seen in the Urgent Care Department. The alleged overcharges submitted to the free care pool were designed to compensate providers that are not normally open after 10 p.m., on Sundays, holidays, or for emergencies. The Urgent Care Department at East Boston Neighborhood Health Center is open for urgent care and emergencies 24 hours a day, 7 days a week. By submitting these charges, the government alleged that the community health center increased its overall reimbursement from the Uncompensated Care Pool during fiscal years 2003 to 2006.
The investigation was handled jointly by Assistant Attorney General Ann Ackil from the Massachusetts Attorney General’s Office, Medicaid Fraud Division and Assistant U.S. Attorney Patricia Connolly in Sullivan’s Civil Division. They were assisted by investigators from their respective offices and analysts with the Massachusetts Division of Health Care Finance and Policy.
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