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Thursday, Apr 19, 2018
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Shands settles medical claims lawsuit for $26 million

Shands Healthcare, which runs a six-hospital network in Florida, will pay the federal government and Florida a total of $26 million to settle allegations of false claims to Medicare, Medicaid and TRICARE, according to a release from the Department of Justice.

The facilities – Shands Teaching Hospital & Clinics Inc., Shands Jacksonville Medical Center Inc. and Shands Jacksonville Healthcare Inc. – billed state and federal health care programs from 2003 to 2008 for inpatient servies and procedures that should have been recorded as outpatient care, the release said.

The six Florida hospitals were named as defendants in a whistleblower lawsuit brought under the False Claims Act, which permits private citizens to sue on behalf of the government and receive part of any award. The lawsuit was filed in federal district court in Jacksonville, by Terry Myers, president of a healthcare consulting firm, YPRO Corp. Of the $26 million settlement, $25.1 million will go to Medicare and other federal health care payors. The settlement also resolved allegations under the Florida False Claims Act; the state of Florida will receive $829,600. Myers’ portion of the award has yet to be determined.

The six Florida hospitals are: Shands at Jacksonville; Shands at Gainesville, also known as Shands at the University of Florida; Shands Alachua General Hospital; Shands at Lakeshore; Shands Starke; and Shands Live Oak.

Since January 2009, the Justice Department has recovered more than $14.8 billion through False Claims Act cases, with more than $10.8 billion of that involving fraud against federal health care programs.

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