BALTIMORE (AP) — Maryland General Hospital faces a state Medicaid fraud investigation after problems were found in the hospital’s laboratory.
The state Attorney General’s Office is examining whether the hospital fraudulently billed the state Medicaid program for lab tests that employees knew might be inaccurate.
Maryland General also is being sued by a former doctor who says the 243-bed facility routinely overcharged the federal Medicare program for anesthesiology services.
Several state government sources confirmed that the Medicaid fraud probe is under way, the (Baltimore) Sun reported.
Kevin Enright, a spokesman for Attorney General J. Joseph Curran Jr., said he could neither confirm nor deny an investigation.
Hospital spokesman Lee Kennedy issued a statement late Tuesday acknowledging lab billing issues, but it did not address the lawsuit filed by the former doctor.
“As we examined issues related to the validity of test results at Maryland General Hospital over the last two months, we are also examining billing matters related to these tests,” he said. “Payers may have been billed for — and Maryland General reimbursed for — test results that were potentially invalid.”
The Medicaid probe was initiated after state health inspectors, prompted by the complaint of a former Maryland General lab technician, found a laboratory operation “rife with equipment malfunctions.”
Inspectors found that the hospital sent out HIV and hepatitis test results to 460 patients, though instrument readings indicated the results might have been inaccurate.
The lawsuit against the hospital was filed in 2002 by Dr. Adam F. Dorin, who ran Maryland General’s anesthesiology department in 2001 and 2002.
He is suing under a federal “whistleblower” law and charges that hospital officials “routinely submit false claims for the services of anesthesiology professionals.”
Though the file in the lawsuit remains sealed, in conformance with the whistleblower law, records obtained by the (Baltimore) Sun established that it was filed by Dr. Dorin.
In response to the critical state inspection reports concerning its lab, Maryland General late last week filed a 244-page plan of correction that includes steps already taken, such as the hiring of an outside consulting firm to run the lab on an interim basis and the appointment of a new medical director for the facility.
An interim report from the consulting firm concludes that the laboratory was not understaffed but that a high turnover rate and poor management led to problems.
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