A New York State hospital has agreed to pay the U.S. Department of Justice more than $3.3 million to resolve an investigation conducted by the HHS-OIG and U.S. Attorney’s Office for the Northern District of New York into whether the hospital properly billed Medicare for services furnished in a provider-based mobile hyperbaric oxygen unit. According to the October 15, 2014 settlement agreement, Our Lady of Lourdes Memorial Hospital disclosed to the Government that it had “improperly” submitted claims for hyperbaric oxygen therapy over a six-year period as if such services were furnished in a provider-based mobile unit, even though the unit did not comply with the requirements of the Medicare provider-based regulation, 42 C.F.R. § 413.65.
The settlement agreement does not specify the elements of the regulation with which the unit was not in compliance, but notes that the unit was operated by a separate company, Mobile Hyperbaric Centers, LLC, and not the hospital. The settlement agreement is available here.