Saturday, March 30, 2013

UCI Medical Center settles federal fraud case

The headline focuses on the wrong aspect of this case, in my opinion. It's not just the million dollar plus fraud that's the biggest problem here. It's that the fraud was occasioned by the practice of not providing promised, and billed-for, services. 


This is very like a 2001 case, which I believe is Krahel et al v Regents of University of California. I believe that case is one in which Regents eventually settled, for $22.5M, claims of "routine misbilling" which claims allegedly revolved around charging for the services of attending physicians who were not even in the hospital at the time the services were performed. Very similar to the 2013 case described in the link on this blog post. 

In the 2013 case, the promised and billed-for service was attending physician supervision during anesthesia. Something to consider if you plan to undergo anesthesia at a University of California facility. 

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