News in brief - Sept. 11, 2006

Cleveland hospital system settles whistle-blower lawsuit - Medicare wants back millions in accidental Part D payments

Cleveland hospital system settles whistle-blower lawsuit

University Hospitals of Cleveland on Aug. 18 agreed to pay $13.9 million to settle a federal false claims lawsuit arising from alleged anti-kickback violations. University Hospitals denies any wrongdoing.

The U.S. attorney for the Northern District of Ohio intervened in a 2003 whistle-blower lawsuit filed by Thomas J. Kirby, MD, a cardiothoracic surgeon who formerly worked at University Hospitals of Cleveland. Dr. Kirby alleged that the health system had entered into improper financial arrangements with doctors to induce them to refer patients and then billed Medicare for the services provided.

Under the terms of the settlement, Dr. Kirby will receive $1.5 million, plus attorney's fees.

Medicare wants back millions in accidental Part D payments

The federal government erroneously sent nearly $50 million to Medicare Part D beneficiaries and will require the money back.

The Centers for Medicare & Medicaid Services revealed that it had sent incorrect payments to more than 200,000 beneficiaries along with a letter informing them that the Social Security Administration would stop deducting Medicare drug premiums from their Social Security checks. CMS sent a follow-up letter apologizing for the error and asking affected seniors to set the inadvertent payments aside.

At press time, the agency had not announced how it would recoup the overpayments, which averaged about $200 each. Patient advocates and at least one lawmaker called on CMS to take back the money in small increments over time to avoid punishing seniors who had already spent it.