Newark St. Michael’s Hospital Settles Lawsuit For $450K: Prosecutors

Newark, NJ - Saint Michael's Medical Center in Newark has agreed to pay $450,000 to resolve allegations that it falsely billed Medicare and Medicaid for medically unnecessary cardiac procedures, prosecutors announced Monday.

According to the U.S. Attorney’s Office (NJ), the settlement resolves allegations that between January of 2009 to January of 2015, Saint Michael's submitted claims for percutaneous coronary interventions, catheterizations and stents performed in its cardiac catheterization lab that were “not medically necessary.”

Prosecutors stated that the allegations were raised in a lawsuit filed under whistleblower provisions of the False Claims Act, which allows private citizens with knowledge of fraud to bring civil actions on behalf of the government and to share in any recovery.

“Under Medicare and Medicaid rules, health care providers have a duty to provide services only when they are medically necessary,” prosecutors stated in a news release. “In addition, government health care programs only authorize payment for reasonable and necessary medical services.”

The claims settled by the agreement are only allegations and there has been no determination of liability, prosecutors stated.

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File photo: Flickr Commons, www.medisave.co.uk