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DOJ reveals Moffitt to repay over $19 million for Medicare and other program billing errors



DOJ reveals Moffitt to repay over $19 million for Medicare and other program billing errors

TAMPA, Fla. — The Moffitt Cancer Center & Research Institute Hospital has agreed to a payment of $19,564,743 for the improper billing of Medicare and other federal health care programs, as stated by the Justice Department.

The settlement, announced by the DOJ, addresses Moffitt’s civil liability concerning claims submitted to Medicare and various federal health care programs from 2014 to 2020. These claims were for services deemed ineligible for reimbursement under The Centers for Medicare and Medicaid Services (CMS) rules.

Moffitt improperly billed insurance programs for clinical trial research services that were intended to be billed to non-government trial sponsors.

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Upon discovering this issue, Moffitt initiated an independent investigation and compliance review. Subsequently, the hospital shared its findings with the federal government.

“Moffitt cooperated fully with the government’s investigation of the conduct and implemented prompt and substantial remedial measures,” the DOJ said in a press release.

As per the DOJ, the federal portion of the settlement amounted to roughly $18.2 million, with the state Medicaid share of the settlement totaling around $1.3 million.

In a statement to WFLA, Moffitt said after discovering their incorrect billing they “quickly worked with the federal government to ensure substantial remedial measures were taken to avoid this from happening moving forward. Federal government billing standards driving what can be billed to federal programs (such as Medicare) are highly complex, and compliance with these billing standards requires continuous and concerted vigilance.”

“Moffitt has fully redesigned its clinical research billing compliance programs to ensure adherence with all applicable federal government billing standards. Clinical research programs are a critical part of advancing cancer care. Moffitt’s clinical research programs continue to be safe and effective, and this did not affect the finances or quality of care provided to patients at Moffitt.”

“Protecting the nation’s healthcare programs is a top priority of our office,” U.S. Attorney Roger B. Handberg for the Middle District of Florida said. “When those who receive funds from government healthcare programs discover that they have submitted improper claims, we encourage them to promptly disclose the issues and cooperate fully with investigators to reach an appropriate and swift settlement. That’s what Moffitt did here: self-reported its improper claims, cooperated with government investigators and took action to remediate its billing systems.”



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