Pikeville hospital, U.S. settle Medic...

Pikeville hospital, U.S. settle Medicare suit

There are 5 comments on the The Courier-Journal story from Oct 20, 2011, titled Pikeville hospital, U.S. settle Medicare suit. In it, The Courier-Journal reports that:

Pikeville Medical Center has settled a whistleblower lawsuit with the federal government alleging that it improperly billed Medicare for work done in a pain management clinic.

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We may never know

Winchester, KY

#1 Oct 21, 2011
Pikeville hospital, U.S. settle Medicare suit


2:52 PM, Oct. 20, 2011 |
Comments

Pikeville Medical Center has settled a whistleblower lawsuit with the federal government alleging that it improperly billed Medicare for work done in a pain management clinic.

U.S. District Judge David Bunning on Thursday unsealed the suit, brought by Dr. Michael Fletcher on behalf of the federal government against Pikeville Medical Center.

Fletcher, who worked as the director of the pain management clinic at the hospital from May 2005 through July 2007, accused the hospital of overbilling Medicare in the pain management, radiation oncology and medical oncology units.

Kyle Edelen, a spokesman for the U.S. Attorney’s office in Lexington, said the hospital paid $36,138, with Fletcher receiving $7,228 for bringing the allegations to the government. The hospital did not admit wrongdoing as part of the agreement.

Neither Cindy May Johnson, a spokeswoman for the hospital, nor Fletcher’s attorney, Nicholas Bunch of Cincinnati, responded immediately to phone calls seeking comment.

According to minutes filed in the court record, no one from the hospital attended the final hearing Wednesday, and no attorney filed a notice of appearance on behalf of the hospital.

Fletcher, whose medical license shows a practice in Crestview Hills in Northern Kentucky, said in the suit that a pain management practice consultant reviewed the Pike County hospital’s practices in March and April 2007.

The suit said the consultant, Linda Van Horn of Kansas City, Mo., found that the hospital’s Leonard Lawson Cancer Center overbilled Medicare $300,000 during the time she examined the facility’s operations.

The hospital used improper billing codes for the pain management clinic, which indicated services were provided in a private physician’s office, rather than the clinic, Fletcher said. He said similar practices were used in the radiation oncology and medical oncology units.

Fletcher said he met with both Walter May, the hospital’s chief executive officer, and Jerry Johnson, its chief operating officer, about the billing issue. Johnson dismissed the billing issue as “no big deal” and said it would be “taken care of,” Fletcher said.

Fletcher alleged that the hospital took no steps toward dealing with the problem.

Fletcher brought the suit under the federal False Claims Act, which allows whistleblowers to sue entities receiving federal funding over alleged wrongdoing. The government may seek to collect penalties of between $5,500 and $11,000 for each violation proven.

In turn, a whistleblower may be awarded a portion of any judgment or settlement.

It was unclear Thursday if the hospital was penalized and whether Fletcher received any monetary award from the settlement.
Wow

Winchester, KY

#2 Oct 21, 2011
7'228 dollars was his award. Written plain as day in the fourth paragraph. I wonder why such news is never published in the Paper.
panthermom

Elkhorn City, KY

#3 Oct 28, 2011
Wow wrote:
7'228 dollars was his award. Written plain as day in the fourth paragraph. I wonder why such news is never published in the Paper.
Dear WOW, do you not understand Walter May OWNS all pikeville, pike county media????
BUCKFIELD

Winchester, KY

#4 Nov 9, 2011
you can bet walter may was the ring leader.
curious

Winchester, KY

#5 Nov 15, 2011
is the hospital bad?

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