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Healthcare coverage from WYPR is made possible by support from GBMC HealthCare.

Maryland health organizations agree to pay $2M DOJ settlement over Medicare, Medicaid claims

A sign points visitors toward the financial services department at a hospital.
David Goldman/AP
/
AP
A sign points visitors toward the financial services department at a hospital.

An acute care hospital and radiology imaging center in Prince George’s County agreed to pay $2 million to the Department of Justice which resolves allegations the Lanham-based companies filed false Medicaid and Medicare claims.

The settlement deal means neither company admits to any wrongdoing.

Prosecutors claim that between March 2010 and October 2020, Luminis Health Doctors Community Medical Center Inc. and Diagnostic Imaging Associates incorrectly billed for services conducted at Health Doctors Community Medical Center’s outpatient cancer screening office using the radiology group’s provider number with Medicare and Medicaid.

During that time frame, the cancer screening center was not enrolled to participate in Medicare and Medicaid programs. Instead, the radiology group reimbursed the center with Medicare and Medicaid program money through fees for services.

“Health care providers have a responsibility to follow the law, and exploiting insurers for personal gain defies that objective,” said Maureen Dixon, special agent in charge with the Department of Health and Human Services Office of Inspector General in a news release.

In 2019, Anne Arundel Medical Center and Doctors Community Health System merged to become Luminis Health. 

After the merger, the company flagged the compliance issues and self-reported it to the U.S. Department of Health and Human Services, according to Justin McLeod, a spokesperson for Luminis Health.

“Luminis Health has a robust compliance program that seeks to prevent, identify and mitigate potential activity that does not comply with health regulations,” McLeod said. “This self-disclosure demonstrates our commitment and effectiveness of our proactive compliance program.”

Scott is the Health Reporter for WYPR. @smaucionewypr
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