Mercy Medical Center in Sioux City has agreed to pay the federal government $400,000 to settle allegations that it violated the False Claims Act by inflating charges for heart patients’ care.
The settlement resolves allegations that Mercy inflated charges for Medicare, Medicaid, Tricare and Federal Employees Health Benefits Program heart patients to obtain additional reimbursement from those federal health care programs. Congress provided for additional payments, called outlier payments, to provide an incentive for hospitals to treat patients when the cost of care is unusually high.
According to court documents, the government alleged that between March 1999 and August 2003 the hospital inflated its charges for certain inpatient heart procedures, and accepted payment for the same. The government also contends that Mercy submitted false and misleading statements involving Medicare and Medicaid cost reports for Oakland Memorial Hospital in Oakland, Neb. during fiscal years 2003 through 2006.
The monetary agreement did not require Mercy to admit to wrongdoing.
“Health care providers knowingly overcharging federal health care programs will be made to pay the price,” said Stephanie Rose, U.S. Attorney for the Northern District of Iowa. “The integrity of the federal health care system for the citizens of Iowa depends on honest dealings, and this office will continue to root out fraudulent claims.”








