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Duke University, Agrees to Pay $1 Million for Alleged False Claims Submitted to Federal Health Care Programs

by | Mar 24, 2014 | Firm News

RALEIGH – United States Attorney for the Eastern District of North Carolina Thomas G. Walker and North Carolina Attorney General Roy Cooper announced jointly that Duke University Health System, Inc. (Duke University Health System) has agreed to pay $1 million to resolve allegations under the U.S. and North Carolina False Claims Acts that it made false claims in conjunction with certain services provided to beneficiaries of Federal health care programs (Medicare, Medicaid, and TRICARE).

Duke University Health System is a non-profit corporation that operates three hospitals: (1) Duke University Hospital, (2) Duke Regional Hospital (formerly known as Durham Regional Hospital), and (3) Duke Raleigh Hospital (formerly known as Duke Health Raleigh Hospital). Duke University Health System allegedly made false claims to Medicare, Medicaid, and TRICARE by (1) billing the government for services provided by physician assistants (PA’s) during coronary artery bypass surgeries when the PA’s were acting as surgical assistants (along with graduate medical trainees), which is not allowed under government regulations and (2) increasing billing by unbundling claims when the unbundling was not appropriate, specifically in connection with cardiac and anesthesia services.

“Allegations of health care fraud will be zealously pursued in North Carolina,” said U.S. Attorney Thomas G. Walker. “We encourage our citizens to report potential health care fraud to the appropriate authorities. Duke Univesity Health System was forthcoming with information, and was cooperative in the investigation and resolution.”

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