HCA paying $405,000 to Nevada for overbillings

Friday, Dec. 15, 2000 | 11:09 a.m.

CARSON CITY -- The company that owns Sunrise and MountainView hospitals in Las Vegas has agreed to repay the state $405,000 in overbillings of Medicaid patients. The state may receive additional payments later.

Attorney General Frankie Sue Del Papa announced Thursday the state and HCA-the Healthcare Co. have reached a settlement that concluded there was no criminal wrongdoing by its Sunrise hospital or its employees.

Deputy Attorney General Mark Kemberling, of the Medicaid Fraud Unit, said this settlement was apart from the one announced Thursday by the U.S. Department of Justice in which HCA-the Healthcare Co. agreed to plead guilty to criminal conduct.

In April 1998, the attorney general's office, armed with subpoenas, seized hundreds of boxes of records from Sunrise Hospital and from its warehouse in Las Vegas. Since then, the state's investigation has been proceeding.

A good part of the overpayment to Nevada Medicaid patients was done through an automated billing system. Kemberling said a Medicaid patient may have been required to have one or two tests but a number of other tests were performed. "There were non-essential tests," Kemberling said.

Del Papa and Tim Terry, director of the fraud unit, said HCA has instituted a series of corrective measures to prevent these errors in the future.

Del Papa said she anticipates additional revenue coming to Nevada as a result of negotiations. Officials from Nevada, Ohio, Tennessee and Washington are on a negotiating team representing all the states where HCA had hospitals.

She expects a tentative agreement in those negotiations will be approved in the near future.

Kemberling also said Nevada should receive some money from the federal case.

Del Papa and Terry said the hospital company and its representatives "had been extremely cooperative during the two-year investigation, sharing hundreds of thousands of documents with federal and state investigators in seeking to address its corporate responsibility for the actions at issue."

Medicaid is a program in which the state and federal government each pay 50 percent to cover health care for needy citizens.