Oklahoma Heart Hospital Pays $2.8 Million Settlement for Fraudulent Medicaid Billing Practices

A whistleblower in Oklahoma, Jennifferr Baird, filed a complaint against the hospital she worked at as a registered nurse for fraudulent Medicaid billing practices. Following the filing, Oklahoma Heart Hospital agreed to settle the allegations with a $2.8 million fee.

Baird was in charge of a team of seven staff members and alleged that for at least seven years the hospital consistently billed Medicaid at inpatient rates, even if the patient was being treated as an outpatient.

“First, OHH routes almost all of its Medicaid patients to inpatient treatment, when many should be classified as outpatient; in doing so OHH is able to charge significantly larger fees for the same treatment. The fraud is evidenced by the fact that OHH does not treat its Medicare or privately insured patients similarly.”, the lawsuit stated.

The lawsuit further explained, “Second, OHH fraudulently manipulates its re-hospitalization rate of Medicare patients to induce the government to pay it a bonus,”.

While the hospital did not admit to any of the alleged wrongdoing, they agreed to pay a $2.8 million dollar settlement fee and will be enforcing a new “corporate integrity agreement”.

Baird originally filed the complaint in 2015 and was represented by the Employment Law Group firm and Allison Legal firm. For her efforts in bringing this case to the attention of the government, she will receive a part of this settlement.

To learn more about this case or other instances of Medicaid fraud, visit the Jeff Newman Law Whistleblower Help Center and blog!