A Houston medical center accused of filing false Medicare claims has agreed to pay more than $21 million in a settlement.
According to a press release, employees of Cornerstone Healthcare Group Holding Inc. and CHG Hospital Medical Center LLC., doing business as Cornerstone Hospital Medical Center, allegedly performed improper or unauthorized medical procedures before fraudulently submitting claims to Medicare.
“Taking advantage of the elderly and infirm is disgraceful,” U.S. Attorney Alamdar Hamdani said in the Feb. 22 press release. “When providers accept federal funds for reimbursement, they have a duty and responsibility to provide the necessary and best care possible to the patient. As one of the largest of its kind in our district, this settlement shows our commitment to protecting our most vulnerable citizens and the integrity of the Medicare system.”
The fraudulent practices of the medical center were uncovered when an employee at the Cornerstone Medical Center filed a whistleblower lawsuit on Sept. 28, 2018. According to court documents, the employee witnessed unlicensed, unauthorized students rendering medical procedures which were billed to Medicare. Under the False Claims Act, the whistleblower received $4,327,502 as part of the recovery.
In addition, records show the facility billed for services rendered by physicians that were out of the country and could not have performed the services. An investigation also uncovered that the facility billed for services not supported by the patients’ diagnosis or medical records, billed for services not rendered or "so inadequate they were worthless."
“This $21.6 million settlement by Cornerstone Healthcare Group Holding is one of the largest civil health-care fraud settlements FBI Houston has seen, and we work a lot of health-care fraud cases. I hope this case sends a message to other health-care providers who think they can get away with similar fraud,” FBI Special Agent in Charge James Smith said in the press release.
Smith went on to describe the impact on patients and the violation of the trust they put in their doctors.
“Not only did Cornerstone Healthcare bilk the Medicare program out of millions of dollars, it also took advantage of its patients who were unknowingly used for its scam. These patients trusted their doctors and health-care providers and ultimately received little to no care," he said. "At the end of the day, health-care fraud affects everyone. It raises our health insurance premiums and exposes patients to worthless and unnecessary medical procedures. I’m proud of the work our FBI Houston Healthcare Fraud Task Force has done.”
According to the press release, Cornerstone Medical Center is no longer in business.
