DENVER (AP) — Denver Heath Medical Center has agreed to pay more than $6.3 million to settle allegations that it overbilled Medicare and Medicaid by misclassifying some patients it admitted between 2006 and 2009.
A former internal auditor had filed a whistleblower lawsuit alleging Denver Health was inappropriately admitting some patients as "inpatient." Medicare and Medicaid reimburse hospitals at higher amounts when patients are admitted as "inpatient" rather than "outpatient" or in "observation" status.
Denver Health said Thursday that it settled to avoid protracted litigation. It says hospital billing is complex, and it was already working on its billing accuracy when it learned prosecutors were examining the issue.
Prosecutors say Colorado will receive about $1.1 million of the settlement proceeds, the U.S. will receive almost $5.2 million, and the whistleblower will receive nearly $818,000.