The hospital has been admitting patients for spinal compression fractures or kyphoplasty procedures that could be done on an outpatient basis. All violations investigated included over charging when the procedures were again outpatient. All of this happened between 2006 and 2010. The former employee stands to make around $6 million for her part in the investigation as a whistle blower. Things have changed around Dignity since this time as Optum/United Healthcare and the Hospital system together created a new billing/revenue cycling system company called Optum 360, to where people are employed to do all the revenue cycling under this company name and they are busy hiring more people to work on staff at Dignity hospitals.
United Healthcare Adding Yet One More Subsidiary to the Very Large Number of Subs They Already Own/Operate-Optum and Dignity Healthcare (A System Wide Cerner EHR Client) Form New Venture Called Optum 360–Subsidiary Watch
Dignity is the 5th largest hospital system in the US. BD
Dignity Healthcare has decided to settle allegations of patients having been over-charged rather than fight them in court. Dignity Healthcare, commonly known as Catholic Healthcare West, is one of the largest hospital networks in the US. It has hospitals in Arizona, California and Nevada with 39 hospitals in total. To date, 13 of the hospitals have been accused of over billing patients for services that should have been outpatient services or for services that are completely unnecessary.
And to make them sound less “dignified,” the hospital groups have been over-charging patients on government funded medical programs. This means, they have been one of the factors in rising taxes to pay for public medical programs such as Medicare and Tricare. Tricare is military healthcare services.
“Charging the government for higher cost inpatient services that patients do not need wastes the country’s vital health care dollars,” said Acting Assistant Attorney Joyce R. Branda for the Justice Department’s Civil Division.
The hospital has agreed to settle out for $37 million in leiu of the ordinance filed by a former employee named Kathleen Hawkins. She filed the ordinance in the US district court for the Northern District of California, and she is set to receive 6.25 million dollars in the settlement herself.