Vermont received $21,789, New Hampshire received $8,242 and the federal health care programs received over $500,000.
"The United States contends that the regulations and guidelines related to billing and coding are direct and clear and that failure to abide by these requirements constituted, at minimum, reckless disregard under the False Claims Act," the press release said.
This instance marks the second time in the past two years that Dartmouth-Hitchcock healthcare system has settled over a billing discrepancy claim. Last year, the hospital paid over $2.2 million as remediation for documentation and billing errors in its anesthesiology and radiology departments.
The investigation of the billing discrepancies began in 2009 after Dartmouth-Hitchcock self-disclosed that one physician in the neurology department had improperly billed the federal government. After the U.S. Attorney's Office investigated the claim, it discovered that at least five other physicians in the department had also engaged in improper billing practices from 2004 to 2008, the press release said.
Although DHMC denied any liability, the hospital and the federal government decided to settle in order to avoid the "burden, expense and risks" of litigation and a trial, according to the press release.
The press release also noted that Dartmouth-Hitchcock was cooperative in the investigation and undertook the "burden of engaging in significant audits at the government's request and undertaking corrective action."
Assistant U.S. Attorney for the District of Vermont Nikolas Kerest did not comment on whether he thought the overbilling was intentional but said that it was committed, at a minimum, with "reckless disregard," which still is a violation of the False Claims Act.
"We felt we could show that Dartmouth-Hitchcock submitted false claims to the government, either knowingly or with reckless disregard." Kerest said.
Assistant Attorney General Edward Baker, who represented the state of Vermont in the claim, declined to comment on whether a billing system problem currently exists at DHMC, because the alleged errors occurred several years ago.
"Clearly, it's our view that in the past, there have been problems." he said. "Whether there is a problem today, I can't say. I would hope the problems would have been rectified."
Baker also said that improper billing practices that violate the False Claims Act are not uncommon among hospitals.
"There's a tremendous amount of fraud, waste and abuse out there, and this would be one example," he said.
Baker recommended that the clinic improve its compliance programs by reading the provider enrollment agreement, understanding the relevant law and training and retraining appropriate personnel.
Representatives from Dartmouth-Hitchcock declined requests for comment but said in a press release that the billing errors "were made by excellent physicians in an increasingly complex billing and coding environment."
The release also said that the clinic cooperated fully in the investigation and that the claim did not affect the quality of care at Dartmouth-Hitchcock Medical Center. The hospital hopes to improve its billing practice to meet the standards of compliance, the release stated.
"We welcome the opportunity to improve our practices," the release said. "We have been making continuous improvements in training, education and review of our documentation procedures, and strengthening our mandatory compliance education program. We will continue to refine and strengthen those procedures and programs going forward."
