MOULTRIE — For public review now on the Web site of the Office of the Inspector General of the Department of Health and Human Services is the corporate integrity agreement entered into by Colquitt Regional Medical Center (CRMC) after a a fraud investigation wrapped up earlier this year.
CRMC’s attorney John Carlton in an earlier interview said that the corporate integrity agreement was a condition of the hospital’s $475,000 settlement with the government. Also an independent review organization is to randomly pull charts at the end of each year and examine claims.
CRMC has been conducting its own internal monitoring since 2004, Carlton has said, and since July of 2004, the error rate has dropped significantly.
The investigation came after Joyce Dickerson, former director of CRMC’s Home Health Services, lodged claims of harassment and losing her job after she informed CRMC’s administrator and the hospital authority that she suspected that the Sylvester Home Care office was filing fraudulent claims mainly to Medicare and to a lesser extent Medicaid. CRMC earlier settled with the U.S. Justice Department to repay $475,000 for fraudulent claims to Medicare and to a far lesser extent, Medicaid. Billings out of the Sylvester office during the time in question were about 40 percent higher on average than the Moultrie office, Carlton said. CRMC officials have said that there was no intent to defraud the government.
After mediation, the government and CRMC agreed on an error rate of about 20 percent in the 496 cases the Sylvester Home Care office handled from 2001 through 2005, the time frame in which another former CRMC employee Colleen Grimsley was director of Sylvester Home Health Care.
The corporate integrity agreement (CIA) will run for five years. A compliance officer and committee comprised of senior management will oversee CRMC’s commitment to full compliance with all federal health care program requirements, including its commitment to prepare and submit accurate claims, the CIA said.
Also, an independent review organization, such as an accounting, auditing or consulting firm with expertise in the billing, coding, reporting and other requirements of home health care and in the general requirements of the federal health care programs from which the hospital seeks reimbursement, the CIA said.
On the Internet: http://oig.hhs.gov/fraud/cia/index.html and click on Colquitt Regional Medical Center.
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CRMC integrity agreement posted on Web
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