Yavapai Regional Medical Center, an Arizona not-for-profit community health system, has agreed to pay the United States $5.85 million to resolve claims that it violated the False Claims Act by misreporting data about the hours worked by its employees on its annual cost reports, which improperly inflated the amount of money it received from the Medicare program.
The settlement resolves a lawsuit filed in April 2016 by Gregory Kuzma under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and share in any recovery. The case was filed in the United States District Court for the District of Arizona.
Kuzma will receive $1.17 million as his share of the settlement payment that resolves the qui tam suit he filed.
The United States alleged that between 2006 and 2009, Yavapai misreported the hours worked by its employees, which inflated the wage index for the Prescott, Arizona area. The United States alleged that the artificially inflated wage index was used by the Medicare program when it calculated the amount of the payments it made to Yavapai. The United States also alleged that as a result of Yavapai’s false claims, federal health care programs paid substantially more than was warranted. The settlement is neither an admission of liability by Yavapai, nor is it a concession by the United States that its claims are not well founded.
“Falsifying records and extracting unwarranted funds from Medicare will be detected and stopped,” said Christian J. Schrank, Special Agent in Charge for the Los Angeles Region of the United States Department of Health and Human Services, Office of Inspector General. “Medicare funds are intended to care for patients, not line the pockets of providers who submit false claims.”