- The Washington Times - Friday, December 15, 2000

HCA The Healthcare Company, the largest for-profit hospital chain in the nation, yesterday agreed to pay $840 million in criminal fines, civil penalties and damages for unlawful billing practices, the Justice Department said.

The agreement is the largest fraud settlement ever reached by the Justice Department.

"Health care fraud impacts every American," Attorney General Janet Reno said in announcing the settlement. "When a company defrauds our nation's health care programs, it takes money out of the pockets of the American taxpayers. It is wrong."

In what Miss Reno described as the largest multi-agency investigation ever undertaken by the government, HCA will pay a total of $745 million to resolve accusations regarding the manner in which it billed the U.S. government and states for health-care costs, and $95 million in fines and penalties to settle criminal fraud charges.

In a statement yesterday, HCA said it had reached an understanding "in principle" with the Justice Department, but did not elaborate. The agreement, which calls for HCA to plead guilty to 14 counts of defrauding government health-care programs, still must be approved by a federal court.

Formerly known as Columbia/ HCA Healthcare Corp., HCA settled civil-fraud accusations against the company earlier this year. Those charges related to suspected overbilling for lab and home health-care services and overstated patient illnesses to get more money from the government a practice referred to as "upcoding."

The Justice Department said HCA conspired to defraud government health-care programs, paying kickbacks to doctors and submitting false bills. The criminal charges were related to the company's hospitals in Florida, Georgia, Texas and Tennessee.

Two subsidiaries, Columbia Homecare Group Inc. and Columbia Management Companies Inc., agreed under the settlement to plead guilty to numerous fraud charges, including the fraudulent billing of Medicare patients and paying kickbacks to doctors to induce referrals.

The subsidiaries were excluded from participating in the Medicare program.

Miss Reno noted that the settlement resolved only corporate criminal liability, adding that the government has the option to investigate and prosecute any individuals.

She said the plea agreement specifically requires HCA and the two subsidiaries to cooperate with the government in any ongoing investigations.

The settlement ends a five-year criminal investigation of HCA, although the incoming Bush administration could proceed in a civil settlement that could cost the company more than $1 billion.

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