Cornerstone to pay $21M settlement
Federal probe alleges fraudulent Medicare claims
A Houston medical center agreed last week to pay over $21 million to the federal government to settle alleged false Medicare claims submitted after procedures weren’t covered or that were performed so poorly the procedures were deemed “worthless.”
Cornerstone Healthcare Group Holding Inc. billed alleged claims to Medicare for services performed by unqualified and unlicensed medical students, the U.S. Attorney’s Office for the Southern District of Texas said in a news release.
Cornerstone Hospital Medical Center, a former long-term acute care facility that operated as a long-term care hospital until 2020, violated state and federal law by submitting the claims while knowing that unlicensed and unauthorized foreign students of Drs. Jorge Guerrero, Joel Joselevitz and Joseph Varon illegally performed these medical procedures, the release said.
The FBI in Houston and other federal agencies began investigating Cornerstone in 2018 after a whistleblower lawsuit.
Cornerstone and lawyers did not respond to multiple attempts for comment.
Cornerstone also submitted claims for payment for procedures that certain doctors allegedly completed. However, federal investigators found that those physicians were actually out of the country at the time of the procedures, the U.S. Attorney’s Office said.
The investigation concluded that from Jan. 1, 2012, through Dec. 31, 2018, Cornerstone committed fraudulent claims and performed either worthless or unauthorized procedures.
The medical center will pay $21,637,512 in the settlement.
“Taking advantage of the elderly and infirm is disgraceful,” U.S. Attorney for the Southern District of Texas Alamdar S. Hamdani said in the news release.
“When providers accept federal funds for reimbursement, they have a duty and responsibility to provide the necessary and best care possible to the patient.”
The whistleblower will get $4.3 million under the False Claims Act, which allows a private party to file an action on behalf of the U.S. and receive a portion of the money recovered.