Baylor Scott and White Health has escaped an lawsuit alleging they upcoded claims after a Texas judge dismissed a False Claims lawsuit, according to Law360.
The whistleblower lawsuit claims BSW was responsible for more than $61.8 million in fraudulent claims to medicare over seven years. Filed in 2017, the claim says BSW’s medical director led the effort to increase higher billing codes without medical justification.
U.S. District Judge David Ezra said the claimant failed to provide a claim a relief, saying there is nothing wrong with hospitals taking advantage of coding opportunities to increase Medicare payment that is supported by documentation.
“The mere fact that defendants took targeted steps to increase their coding of CCs and MCCs to increase hospitals revenues is neither fraudulent, nor improper per se,” Ezra wrote, reports to Becker’s Hospital Review.
The case was dismissed with prejudice, meaning the plaintiff can’t bring the claims again. Read more here.