Cornerstone Healthcare Group will pay more than $21.6 million to settle allegations it filed false claims to Medicare by inflating the cost of services, billing for unauthorized services, and other violations initially brought forward by a whistleblower.
The allegations were first made by a former Cornerstone employee who filed a qui tam lawsuit in September 2018. The employee claimed unlicensed students were delivering medical care and then billing under the names of physicians.
Cornerstone also submitted claims for physician services when the physicians could not have provided the services because they were out of the country, according to the DOJ.
Cornerstone billed for services that were useless or harmful to patients or not called for by the patients’ medical conditions. These claims were deemed to be fraudulent, the DOJ said.
Because the United States intervened in the lawsuit, the whistleblower is entitled to a portion of the recovery, as called for under the False Claims Act. The whistleblower will receive more than $4.3 million of the penalty assessed against Cornerstone.
“Submitting improper claims to Medicare compromises the financial security of the program and wastes valuable taxpayer dollars,” said Acting Special Agent in Charge Korby Harshaw of the Department of Health and Human Services’ Office of Inspector General.
Cornerstone did not respond to a request for comment.