The University of Miami will pay $22 million to settle allegations that it billed Medicare for unnecessary lab tests, the Justice Department announced Monday.
The government backed whistleblowers’ claims that UM converted multiple physician offices to hospital-owned outpatient departments and billed at the higher rate without giving beneficiaries the required notice.
The university’s electronic health record trigged a preset protocol of tests for every new kidney transplant patient, which was driven by financial motive rather than patient care, investigators alleged. UM allegedly coerced Jackson Memorial Hospital to purchase pre-transplant laboratory tests at inflated rates in exchange for referrals, which led to a separate $1.1 million settlement with Jackson Memorial.
UM did not immediately respond to a request for comment.
“Healthcare providers who charge for medically unnecessary services and knowingly violate billing rules contribute to the soaring cost of health care,” Brian Boynton, acting assistant attorney general for the Justice Department’s civil division, said in prepared remarks. “The department will investigate and hold accountable those who seek to profit at the expense of federal healthcare programs and their beneficiaries.”
Along with the civil settlement, which was spurred by three qui tam lawsuits, UM agreed to a corporate integrity agreement with HHS, which will monitor its billing practices.