St. Vincent Hospital In Worcester To $1.784 million To Medicare

By Tiffany Williams –

In Worcester, Massachusetts on Friday, the Justice Department said “St. Vincent Hospital agreed to pay approximately $1.784 million to resolve allegations that it received impermissible “outlier” payments from Medicare by inflating its charges for cardiac surgical procedures and failed to fully reimburse the government for its receipt of these outlier payments after it became aware of the issue. As part of the settlement, St. Vincent admits that it received outlier payments to which it was not entitled.”

The Justice Department said “St. Vincent admits that between 2018 and 2019, it increased its charges for all inpatient services, including for a cardiac surgical procedure known as a Transcatheter Aortic Valve Replacement (TAVR); once by 18%, and two more times by 15%. St. Vincent’s increased charges resulted in a greater number of Medicare outlier payments, including cases where outlier payments were not appropriate because there were no unforeseen complications or extended lengths of stay that led to the extraordinarily high costs.”

Prior to settling with the United States, St. Vincent made a voluntary payment to the Medicare Administrative Contractor and that voluntary payment the Department said, “Did not fully reimburse Medicare for all outlier payments St. Vincent received for TAVRs and other cardiac-related surgical procedures in cases where patients did not require an increased level of care or an extended length of stay resulting in extraordinarily high costs.”

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