According to a DoJ press release, Savannah-based Optim Healthcare has agreed to pay $4 million to resolve allegations that it submitted false claims to the Government.  The Government alleged that Optim Healthcare submitted claims to Medicare that were improperly inflated, up-coded for reimbursement, and in violation of the Stark Law which prohibits physician self-referrals, at its Tattnall County hospital and Savannah ambulatory surgical center.  The investigation began after the Government received numerous complaints from patients living in the Savannah area who were required to undergo major surgeries at the rural hospital in Tattnall County, 90 miles from Savannah, and a whistleblower filed a lawsuit under the qui tam provisions of the False Claims Act.  The Government alleges that the primary motivation for having the surgeries performed at the physician-owned Tattnall hospital was financial.

“Today’s settlement demonstrates that the OIG will aggressively investigate all allegations made against trusted healthcare providers who misrepresent services and violate the Physician Self-Referral Statute,” said Derrick L. Jackson, Special Agent in Charge of the United States Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office.

To report Medicare fraud, please contact Frohsin & Barger.