DOJ orders Cape Cod Hospital to pay $24.4M over false claims

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The Department of Justice (DOJ) ordered Cape Cod Hospital to pay nearly $24.4 million to settle alleged False Claims Act violations that it knowingly submitted claims to the government for procedures that failed to comply with Medicare rules.

Cape Cod Hospital will pay more than $14 million in restitution to the government, according to its settlement agreement. The hospital entered into a five-year corporate integrity agreement (CIA) with the Department of Health and Human Services’ Office of Inspector General requiring annual review of its paid Medicare claims by an independent review organization, the DOJ announced in a press release Thursday.

The settlement resolves claims brought under the qui tam provisions of the False Claims Act by Richard Zelman, a former physician at the hospital who alleged he was retaliated against and fired for blowing the whistle, the Cape Cod Times reported. He will receive about $4.3 million and approximately $121,000 to cover expenses, attorney’s fees, and costs related to the civil action.

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