DENVER, Colo. (KKTV) – University of Colorado Health has agreed to pay $23 million to resolve allegations that it violated the False Claims Act by seeking and receiving payment from federal health programs for service visits emergency, according to the U.S. Attorney’s Office in Colorado. .

The allegations indicate that UCHealth falsely coded certain assessment and management claims, which were submitted to the Medicare and TRICARE systems.

On Tuesday, UCHealth responded to the allegations following the settlement:

“UCHealth is pleased to see the end of this lengthy and resource-intensive investigation. UCHealth denies these allegations, but we agreed to the settlement to avoid potentially lengthy and costly litigation. The settlement allows us to focus our resources on providing excellent patient care.

The U.S. Attorney’s Office said that through these false codings, UCHealth allegedly billed for certain emergency room visits that depicted the highest use of hospital resources when that may not always have been the case.

They said that between November 1, 2017 and March 31, 2021, hospitals would have coded requests for emergency room visits depicting the highest use of hospital resources. Health care providers allegedly checked a patient’s vital signs more times than the total number of hours spent in the emergency room, without taking into account the severity of the patient’s actual medical condition or the hospital resources used to help him.

“Fraudulent billing by health care companies undermines Medicare and other federal health care programs that are vital to many Coloradans,” said Acting U.S. Attorney Matt Kirsch for the District of Colorado. “We will hold healthcare companies accountable that engage in auto-coding practices that lead to unnecessary and inappropriate billing. »

The settlement included claims filed against individual Timothy Sanders in Sanders v. University of Colorado Health et al. The U.S. Attorney’s Office said Sanders received $3.91 million of the settlement proceeds.

Click here to read the full press release.

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