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Feds Get Serious About False Medical Claims; Metro Hospitals Become More Environmentally Friendly

Curtis Davis loads a cardboard baler at St. Anthony hospital in Oklahoma City.
Brent Fuchs
/
The Journal Record
Curtis Davis loads a cardboard baler at St. Anthony hospital in Oklahoma City.

False Medical Claims Investigations in Oklahoma

About seven years ago, the U.S. Attorney General’s office began working with district court prosecutors to crack down on false medical claims. They are investigated all the time, and settlements have become more common in Oklahoma. Many of the investigations are settled before a complaint is filed.

Adam Brooks, the managing editor of The Journal Record newspaper, said most false claims involve overcharging Medicaid.

“That can be you bill for the wrong type of service, you’re billing for services that never actually happened. Sometimes it can even be claiming that a health care provider has certifications they don’t have,” Brooks said. “It may be that those certifications increase the reimbursement rate.”

The U.S. Attorney’s Office for the Western District of Oklahoma has settled nearly $500 million in false medical claims since 2013, according to a Journal Record report by Sarah Terry-Cobo.

“Health care enforcement is very lucrative for the government,” she said. “That is why they devote so much time and so many resources to it.” Damages for false medical claims rise to triple what was originally billed for federal workers’ compensation or Medicaid bills.

Earlier this week, a $2.5 million settlement was reached by the Broadway Clinic of Tulsa and FedCare LLC regarding federal workers’ compensation services that were billed for, but did not happen.

Some lawyers are taking steps to help their clients reduce the number of false medical claims.

“[Law firm] Crowe & Dunlevy talked to us,” said Brooks. “They hold seminars to teach folks how to stay on the right side of the law.”

Metro Hospitals Work To Decrease Environmental Impact

While the government is taking in money from false medical claims, St. Anthony’s Hospital in Oklahoma City is trying to save money by being more environmentally friendly. They have taken a pledge as part of the Healthy Hospitals Initiative, which began in 2012.

Chief Operating Officer Kyle Nondorf talked to The Journal Record’s Sarah Terry-Cobo about the specific steps the hospital has taken to use less energy.

Nondorf said he bought two new air chiller machines for about $950,000 for the main hospital. That equipment is 50 percent more efficient and will help cut down on electricity use. These measures will add up to savings on utility bills, but Nondorf did not have a date when he expects to achieve the return on his investment. He also bought a new air handler machine for about $375,000 to replace a 40-year-old version of the same equipment.

St. Anthony’s is also training staff on new recycling procedures. The hospital is one of five health care organizations in Oklahoma that have become part of the national Healthier Hospitals Initiative.

“It [also] includes the Reynolds Army Community Hospital. They’ve taken those same two pledges St. Anthony’s took. And the OU Medical Center was a founding sponsor of the initiative, so they’re looking at it as well,” Brooks said.

SSM Health is St. Anthony’s parent company and is also trying to reduce medical waste by 10 percent since it is charged by the pound for disposal.

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The Journal Record is a multi-faceted media company specializing in business, legislative and legal news. Print and online content is available via subscription.

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