Center reaches settlement
University Medical Center
and the Health Services
the physician group practice that handles billing for U.Va. doctors,
has reached a $3 million settlement with the federal Justice and
Health and Human Services departments and Virginias Department
of Medical Assistance Services. The settlement, announced Nov.
8, is the result of past billing errors made by the Medical Center
and HSF for federal reimbursements for facility costs rent,
electricity, supplies and salaries for nurses and support staff
at U.Va. outpatient clinics.
to the governments clarification of the rules for payment
of these costs, facility fees were billed by HSF in some instances
and by the Medical Center in others. In a small percentage of
cases, fees were billed inadvertently by both the Medical Center
and HSF. Effective Dec. 1, 1999, the Medical Center agreed to
be the sole agency to bill for facility fees at most outpatient
the Medical Center and HSF will pay $3 million in settlement for
incorrectly billed facility fees, the Medical Center now is eligible
to resubmit corrected billings for these fees and is expected
to recover a like amount.
problem resulted from a lack of billing coordination between the
two systems, said Leonard W. Sandridge, U.Va.s executive
vice president and chief operating officer. As a result,
both the Medical Center and HSF have made significant changes,
including a more sophisticated computer system that links data
from the two organizations and aggressive training programs for
administrators and billing staff.
settlement ends a review process begun in August 1999 at the request
of the Justice Department, and covers more than 71û2 years of
billings, from July 1, 1992, through Dec. 31, 1999. During that
period, total Medical Center billings for Medicare and Medicaid
outpatient visits were approximately $831 million; the $3 million
settlement represents less than 1 percent of total outpatient
part of the settlement agreement, the Medical Center has entered
into a three-year corporate compliance agreement with the government.
Under the agreement, the Medical Center will increase the scope
and frequency of its education for employees on compliance requirements,
especially those who process claims for federal health care programs.
To date, more than 4,000 Medical Center employees and doctors
have completed compliance training.
Medical Centers compliance program complements the existing
compliance office at HSF, which has a staff of seven full-time