Not all patients who are in the ER are admitted, and it is important that those that require in-patient levels of care are treated properly in the ER setting, but recent studies have shown that some for-profit hospital chains enact practices whereby they use quotas or incentives to fraudulently admit patients for inpatient care where such care is not necessary. These practices are implemented because hospitals can charge Medicare (and patients) far more for inpatient care in the ER than even for overnight observation. In patient admission fraud cases have resulted in large settlements for whistleblowers and recovered hundreds of millions of dollars for the government.
Price Armstrong qui-tam attorney Jacob Tubbs recently commented on such practices for the NPR MarketPlace program. You can read or listen to the entire article here: https://www.marketplace.org/2022/10/20/when-should-patients-be-admitted-to-a-hospital-through-the-er-hca/
The qui-tam attorneys at Price Armstrong have extensive experience litigating Medicare fraud under the False Claims Act. If you have information about potential fraud against the government, you may have a valuable claim as a whistleblower. Contact us today for a free initial consultation and review of your case.