Health Management Associates to pay $260 million to settle criminal charges for allegedly defrauding Medicare, Medicaid

Sept. 26, 2018

Health Management Associates has agreed to pay more than $260 million to settle fraud charges that included paying kickbacks to physicians and ripping off federal health programs, the Justice Department said.

HMA, which was acquired by the for-profit hospital Community Health Systems in 2014, paid physicians in exchange for patient referrals and submitted inflated claims for emergency department fees to federal health insurance programs, prosecutors said.

The agreement also resolves several outstanding civil claims against the hospital operator, the DOJ said. An HMA subsidiary that operated under the name Carlisle Regional Medical Center additionally agreed to plead guilty to one count of conspiracy to commit healthcare fraud.

Community Health Systems did not respond to CNBC’s request for comment.

The federal government has been cracking down on overbilling practices by healthcare companies. Last year, the government sued UnitedHealth Group for allegedly overcharging Medicare by hundreds of millions of dollars.

The suit was eventually dropped.

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