Genesys Health System Will Pay $669,413 to Settle Fraudulent Medicare Claims

Grand Blanc, MI–Genesys Health System will have to pay $669,413 to settle claims alleging that the healthcare provider fraudulently submitted claims to Medicare. The U.S. Justice Department announced the settlement on Monday.

The Justice Department originally alleged that Genesys Health System violated the False Claims Act by billing Medicare for higher evaluation and management services than were actually provided to cardiology patients.

The lawsuit was initiated by a whistleblower. According to the provisions of the False Claims Act, private citizens are allowed to sue for fraud on behalf of the U.S. government and share in any recovery. In this instance, the whistleblower will receive $133,882 of the settlement or 20%. According to Terrence Berg, the U.S. Attorney for the Eastern District of Michigan, "whistleblower lawsuits" are important particurlarly with the rising cost of healthcare. Specifically, he stated:

With the rising cost of health care 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. The relator 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. It is important that anyone who has information about alleged fraud on the federal government come forward so we can investigate.