BOCA RATON, FL (BocaNewsNow.com) — A former employee of Boca Raton Regional Hospital alleges in a Federal lawsuit that the hospital knowingly and consistently used improper billing codes for open heart procedures, potentially bilking Medicare out of millions of dollars.
According to the suit, the practice started shortly after Boca Regional Hospital began offering open-heart surgeries and interventional cardiovascular procedure in 2006.
The lawsuit states that the whistleblower, Jeannette Lavoie, “was reviewing the medical necessity criteria required by Medicare for cardiovascular procedures. During the process she became aware that Medicare … was billed incorrectly for a number of moths for certain cardiovascular procedures. Said incorrect billing resulted in a substantial amount of excess billing to Medicare.”
The filing alleges that Boca Regional hospital over billed Medicare by roughly $8-million dollars.
The lawsuit was filed under seal while the Department of Justice reportedly investigated. While local media reports that the DOJ opted not to pursue the case at this time, it could in the future. Lavoie is suing under the “False Claims Act” which allows citizens to sue in an effort to recover money for the government.
You can read the filing by clicking here.
And you can read the denial by Boca Community Hospital here.