Geisinger to pay $18.5 million after violating Medicare rules

The issues occurred between 2012 and 2017.

  • Brett Sholtis

(Harrisburg) — Geisinger Community Health Services is agreeing to pay an $18.5 million settlement after it submitted claims for hospice and home health services that violated Medicare rules, according to The U.S. Attorney’s Office.

“Between January 2012 and December 2017, through several affiliated entities, [ Geisinger ] submitted claims to Medicare for hospice and home health services that violated Medicare rules and regulations regarding physician certifications of terminal illness, patient elections of hospice care, and physician face-to-face encounters with home health patients,” the federal authority said in a news release.

After Geisinger discovered the problems, its leaders “took corrective action” and reported the issue to the U.S. Attorneys office, the news release states.

Acting U.S. Attorney Bruce Brandler said the penalty reflects the priority health systems should put on following the rules.

“Healthcare fraud remains a focus of the Department of Justice and the Affirmative Civil Enforcement Unit of the United States Attorney’s Office,” Brandler said in the news release. “I commend [ Geisinger ] for taking this seriously, voluntarily disclosing these issues to our office and working to address the problems that led to these violations.” Brandler wasn’t immediately available for follow-up questions.

Those violations were the result of an “unintentional error” associated with one health and hospice billing number, said Geisinger spokeswoman Ashley Andyshak Hayes.

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