Genesys Health System to Pay $669K to Settle False Claims Suit

John Commins, for HealthLeaders Media , December 29, 2009

Genesys Health System in Grand Blanc, MI, will pay the federal government $669,413 to settle allegations that it overbilled Medicare, the U.S. Justice Department said.

The government claims that between 2001 and 2007, Genesys violated the False Claims Act by billing Medicare for higher levels of service than were actually given to patients, specifically for evaluation and management services for cardiology patients.

The settlement resolves allegations brought forward in a whistleblower lawsuit by Wendy Buterakos, a contracted auditor who will receive a $133,882 share of the settlement.

"With the rising cost of healthcare and the related pressure on the Medicare Trust Fund, the last thing our nation can afford are providers who are profiteering at the expense of patients. (Buterakos) can be proud that she brought these serious allegations of Medicare fraud to our attention and paved the way for the government to uncover the false claims," said Terrence Berg, U.S. Attorney for Eastern Michigan. "It is important that anyone who has information about alleged fraud on the federal government come forward so we can investigate."

Genesys Health System, a member of Ascension Health, is anchored by Genesys Regional Medical Center at Health Park. The system has operating revenues of more than $410 million, and serves eight counties in central Michigan.

Genesys issued the following statement regarding the matter:

"As part of our stringent Corporate Responsibility Program, Genesys fully cooperated and followed due diligence with the Department of Justice regarding resolution of inadvertent documentation and billing errors related to certain physician claims. This issue did not relate to the quality of care provided to patients. Consequently, the settlement was attained without an admission of liability on the part of Genesys, resulting in the conclusion of this matter."

John Commins is a senior editor with HealthLeaders Media.

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