Feds sue a South Plains hospital for overpayment of Medicare, Medicaid

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SEMINOLE, Texas — The federal government sued the Seminole Hospital District (Memorial Hospital in Seminole and other healthcare locations) on Tuesday and immediately the district agreed to settle for $7 million. 

The lawsuit said the hospital district self-reported overpayments to doctors which happened from 2012 through 2017.  The lawsuit said the hospital district knowingly paid more than market value for services that were billed to Medicare and Medicaid. 

A portion of the lawsuit said:

7. On September 21, 2018, the District delivered a letter to the United States Attorney’s Office for the Northern District of Texas, the Texas Health and Human Services Commission, and the Office of Inspector General for the Texas Health and Human Services Commission (the Disclosure). In the Disclosure, the District states that from 2012 through 2017 it improperly paid physicians more than fair market value for their services. 

8. The United States contends that the District submitted or caused the submission of claims for payment to the Medicare Program, Title XVIII of the Social Security Act, 42 U.S.C. §§ 1395-1395kkk-1 (Medicare) and the Medicaid Program, 42 U.S.C. §§ 1396-1396w-5 (Medicaid) in connection with the District Physicians. 

9. The United States contends that it has certain civil claims against the District arising from the submission of claims for payment to Medicare and Medicaid because the District knowingly paid physicians more than fair market value for their services between January 1, 2012 and December 31, 2017 in violation of the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b). 

CLICK HERE to read the settlement.

The hospital district agrees to cooperate with further investigation by federal authorities.  

The hospital district will pay the money in $500,000 installments between now and December 31, 2025.

EverythingLubbock.com did leave a message late in the afternoon on Tuesday offering the hospital district a chance to comment. An update will be provided if needed.

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