- Associated Press - Friday, March 21, 2014

RALEIGH, N.C. (AP) - State and federal officials say Duke University Health System has agreed to pay $1 million to resolve allegations that it made false claims in connection with services provided to beneficiaries of federal health care programs.

A statement from the U.S. Department of Justice said the health system made false claims to Medicare, Medicaid, and TRICARE by billing the government for services provided by physician assistants when they were acting as surgical assistants, which is not allowed under government regulations.

Officials also said the system increased billing by unbundling claims when the unbundling was not appropriate, specifically in connection with cardiac and anesthesia services.

Prosecutors say the allegations arose from a whistleblower lawsuit filed under the False Claims Act by a former employee of Duke Patient Revenue Management Organization.

A statement from Duke University said the health system had no intent to file inaccurate claims and denies violating the False Claims Act. It said that for purposes of the settlement, it agreed to repay the Medicare, Medicaid and TRICARE programs payments received over a six-year period for claims resulting from an undetected software problem and through possible misapplication of certain technical billing requirements.



The statement also said none of the allegations involved questions about the quality of patient care.

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