UM settles federal Medicare fraud allegations for $22 M

The University of Miami's medical campus is shown in this 2016 photo. Credit: Wikimedia Commons

The University of Miami will pay $22 million to the federal government to settle allegations it cheated Medicare by ordering medically unnecessary test and inflating patients’ medical bills.

The U.S. Department of Justice’s Civil Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida announced the resolution on Monday of allegations raised in a whistleblower case.

Federal law allows whistleblowers to recover a portion of any settlement, but the department said it hadn’t calculated that amount yet.

The university agreed to stiffen its compliance with U.S. Department of Health and Human Services regulations.

“Health care providers who charge for medically unnecessary services and knowingly violate billing rules contribute to the soaring cost of health care,” said Acting Assistant Attorney General Brian Boynton of the Civil Division.

The university had no immediate reply to a request for comment.

The feds accused the university of ordering lab tests for kidney patients at the Miami Transplant Institute, which it runs jointly with Jackson Memorial Hospital, according to a standard protocol, regardless of whether they were medically necessary.

Second, the government says, U.M. required Jackson to pay inflated charges for pretransplant tests as a condition of referring patients to the public hospital.

Finally, the government says U.M. overbilled for treating patients in doctor’s offices while charging Medicaid at the higher rates allowed for treatments in hospital facilities — without providing the legally required notice to patients.