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Hospital is first to settle under voluntary SRDP
$579,000 paid in settlement to CMS
Saints Medical Center in Lowell, MA, announced recently that it will pay $579,000 to settle alleged Medicare billing violations, the first settlement since the publication of the Centers for Medicare and Medicaid Services (CMS) voluntary self-referral disclosure protocol (SRDP).
The issue, which was disclosed in 2010 in connection with the release of Saints' audited financial statement, was related to "certain past relationships between Saints and some of its physicians," and did not involve the quality of patient care or fraud and abuse, according to the hospital statement.
The settlement amount is less than the reserve Saints set aside to address this issue, which was based on management's estimate of the low end of the range of the potential obligation, the hospital reported.
CMS won't reveal the initial overpayment calculation amount, but previous reports about the investigation suggested the repayment amount could be between $785,000 and $14.5 million, says Julie E. Kass, JD, a shareholder with the law firm of Ober, Kaler, Grimes & Shriver, in the Baltimore, MD, office.
Troy Barsky, CMS director of technical payment policy, announced recently that future settlements would be issued on a regular basis and would likely be announced quarterly. About 50 self-disclosures have been submitted through the SRDP, he said. A handful have been accepted, and CMS has requested additional information for others.
"Until more settlements are issued, and with minimal details disclosed by CMS, it will remain difficult to predict the outcome of disclosures for providers contemplating use of the Stark Self-disclosure Protocol for correcting Stark violations," Kass says. "Accordingly, providers should carefully consider their various options for correcting Stark issues, including filing a self-disclosure under the SRDP."
Julie E. Kass, JD, Principal, Ober Kaler, Baltimore, MD. Telephone: (410) 347-7314. E-mail: email@example.com.