11-20-2003 -- Cooper Health Systems -- Settlement -- News Release

Cooper Health System Agrees to Pay $476,500 for Medicare Overbilling

CAMDEN - The Cooper Health System, a healthcare network with one hospital and numerous off-site locations throughout southern New Jersey, today agreed to pay $476,544 to settle claims that it overcharged Medicare, U.S. Attorney Christopher J. Christie announced.

A settlement agreement signed today provides that The Cooper Health System will pay the government $476,544 to settle claims that from July 1995 through June1996 it wrongfully submitted claims for services to Medicare patients that it represented were personally provided by teaching faculty physicians employed by Cooper. The Government alleged that Cooper did not possess required documentary evidence to support those claims, according to Assistant U.S. Attorney Stuart A. Minkowitz.

The settlement is the result of the U.S. Department of Health and Human Services' nationwide initiative to review compliance with the rules governing the Medicare Part B payment for physicians at teaching hospitals, known as the "PATH" initiative.

The settlement comes under the federal False Claims Act that permits the government to seek up to triple damages plus penalties for false or fraudulent claims to the government.

While agreeing to the settlement, Cooper has denied the government's allegations, according to Minkowitz. Cooper cooperated during the Government's investigation and conducted its own internal PATH audit of its Medicare Part B billings to determine whether Medicare Part B reimbursements for professional services provided by Cooper faculty to Medicare beneficiaries were reasonable, allowable, and documented in accordance with Medicare requirements.

Christie credited the Office of Audit Services, Office of Inspector General, Department of Health and Human Services, under the direction of Acting Principal Deputy Inspector General Dara Corrigan, with developing the case.

The Government is represented by Assistant U.S. Attorney Minkowitz, a member of the Affirmative Civil Enforcement Unit of the U.S. Attorney's Civil Division in Newark, and Greg Wellins, of the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services.

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Defense Counsel:

Michael Critchley, Esq. West Orange

Gary Lesneski, Esq. Haddonfield