Healthcare News & Insights

Hospital and University in hot seat for alleged double billing

Northwestern University and Northwestern Memorial Hospital are being accused of double billing for patient care in a whistleblower lawsuit.

Audra Soulias, a former Northwestern University employee, filed the whistleblower lawsuit in November 2010, accusing the university and the hospital of violating the False Claims Act. Specifically, Soulias alleges that both entities billed Medicare and the National Institutes of Health for the same patients’ care.

The lawsuit, however, remained sealed until July 2012 when federal prosecutors, who were reviewing the claims, declined to add the U.S. government as a plaintiff, according to the Chicago Sun-Times. When a lawsuit involves the federal government, it is hidden from the public until federal attorneys can review it and render their decision to participate.

The Daily Northwestern reported that in her complaint, Soulias said, “The hospital, owned and/or operated by the University, has billed and continues to bill both the National Institutes of Health and Medicare for the same care for the same patients in multiple clinical trials.”

Employee laid off

The complaint also said the billing errors were due to the hospital and the Northwestern Medical Faculty Foundation deleting the “research” category for patients from the computer billing system, which prevented the system from categorizing patients as research subjects. By doing this, both private and public insurance were billed for the research services.

Soulias, who claimed she was laid off after she reported the billing system errors to her supervisor, will earn 30% of the funds recovered since the government decided not to participate in the lawsuit, noted Mitch Kreindler, whistleblower assistant and support lawyer. If the government participated, she would earn 25% of the money.

The hospital declined to comment in the Sun-Times report, stating its attorneys only recently received the suit. And a university spokesperson said its attorneys haven’t been formally served with the suit, but believes the university shouldn’t be involved in the lawsuit since it centers around Medicare billing, which the university isn’t involved in.

We will keep you posted on any updates to the lawsuit.

To see the original complaint by Soulias, click here.

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