King's Daughters Medical Center of Ashland has agreed to pay $40.9 million to the US government in a recent court settlement.
The hospital allegedly billed Medicare and Medicaid for invasive and medically unnecessary heart procedures, as well as improper physician referrals. US Attorney Kerry Harvey says that is what his caused his office to take action.
"The allegation was that certain physicians who practice at King’s Daughters were being compensated at excessive, above-market rates, and under the law, when that happens, the billings that are produced by those overcompensated physicians are tainted and subject to recovery," he said.
The settlement is the largest single false claims recovery that the Eastern Kentucky District office has ever handled alone. Harvey adds that due to the money involved in these health care programs, there will always be a need for oversight.
“I think most providers do their work very well and you don’t see these sort of allegations, but there’s just so much money involved in these medical procedures and in federal health care programs these days that there’s always a temptation, I suppose," he said.
With the King’s Daughters settlement, the U.S. Attorney’s Office has now reclaimed over $75 million in medical cases this year, and they hope to remove any further fraud in Eastern Kentucky.
