Queen’s completes oversight agreement

The Queen’s Medical Center officially was released Wednesday from a federal oversight program stemming from whistleblower lawsuits that alleged the hospital overbilled and submitted false claims to government health care programs.

John Nitao, general counsel for the Queen’s Health Systems, said in an email Thursday the organization had “received notification from the (Office of Inspector General, established to fight waste, fraud and abuse in Medicare, Medicaid and other government programs) that the (corporate integrity agreement) is expired.”

The company entered into a “corporate integrity agreement” with the U.S. Department of Health and Human Services, consenting to maintain a compliance program for five years to ensure billings conform to health care program rules.

In 2009 Queen’s paid $2.5 million to settle two whistleblower lawsuits by former pharmacy technicians that alleged the hospital overbilled and submitted false claims from Sept. 8, 1999, to Oct. 28, 2002, to the Medicare program, the state Medicaid program and TRICARE, the federal health benefits program for military dependents, for medication dispensed at the facility.

The government also contended Queen’s wrongfully submitted claims from July 1, 1999, through June 30, 2006, for services performed by resident doctors, which is permissible under Medicare rules only if a teaching physician is supervising them, the settlement agreement said at the time. The complaint sought payment for dispensing antipsychotic drugs ordered by a psychiatrist when they were actually ordered by nonpsychiatric doctors without prior knowledge of a psychiatrist.

Queen’s denied any intentional wrongdoing but agreed to settle the matter “after five years of discussions and negotiations with the government” so that “resources may be spent on providing quality health care rather than on legal fees,” Nitao said at the time.

Under the agreement, Queen’s paid $2 million to the federal government and $500,000 to the pharmacy technicians’ attorneys. The government shared $400,000 of the settlement proceeds with the two whistleblowers.