West Virginia hospital to pay more than $300,000 for Medicare fraud

CLARKSBURG WEST VIRGINIA – U.S. Attorney Bill Powell has announced that Grant Memorial Hospital in Petersburg, West Virginia, has agreed to pay $320,175.71 for false medical claims.

According the settlement, Grant Memorial Hospital filed false claims to Medicare, Medicaid, TRICARE, VA, and Railroad Retirement Programs from September 2014 to March 2016. The claims were for outpatient and inpatient services and items using the National Provider Identifier number and name of a credentialed physician, when, in fact, the services and items were actually provided by a non-credentialed physician.

“This case was the result of the hospital recognizing the mistake and bringing it to the attention of the federal government. I commend the hospital management for ensuring that this wrong was righted. All medical providers should take note, and when a mistake in billing is made, report the issue immediately,” said Powell.

The hospital disclosed the claims in February 2019, pursuant to the Office of Inspector General of the Department of Health and Human Services self-disclosure protocol.

Assistant U.S. Attorney Christopher J. Prezioso litigated the case on behalf of the government. Agencies involved in the investigation and settlement are the Office of Inspector General of the Department of Health and Human Services, the West Virginia Attorney General’s Office, the State of West Virginia Medicaid Fraud Control Unit, the West Virginia Bureau for Medical Services, the Defense Health Agency for TRICARE, and the U.S. Department of Veterans Affairs.

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