"Prosecutors determined that Centura was not intentionally attempting to defraud the government, and that the improper billings were the result of inattention and the negligent acts of lower level employees," U.S. Attorney John Suthers said. "I want to praise Centura for their cooperation in this investigation."
The incorrect billing occurred between Jan. 1, 1991, and Dec. 31., 1997.
Medicaid is a federal-state health insurance program for the poor, and Medicare is the federal health insurance program for people 65 and older.
The U.S. attorney's office in Denver said the Centura Health hospitals submitted incorrect laboratory claims, including two cases in which bills were submitted under more than one code.
Authorities said the hospitals increased their Medicare and Medicaid reimbursements by splitting the claims rather than billing under a single code.
In another case, a hospital billed for blood work that wasn't ordered by a doctor and was not medically "responsible or necessary for diagnosis or treatment," authorities said.
Centura Health voluntarily disclosed some of the billing problem to federal regulators in 2001.
Authorities said none of the cases involved the quality of care provided to individual patients and the settlement does not release Centura Health from any criminal or administrative liabilities.
The incorrect claims were filed by Colorado hospitals Centura Health manages or has managed in the past.
The hospitals are St. Anthony Central, Denver; St. Anthony North, Westminster; Penrose Saint Francis, Colorado Springs; Mercy Medical Center, Durango; St. Thomas More, Canon City; Porter Adventist Hospital, Denver; Avista Adventist, Louisville; and St. Mary Corwin, Pueblo.
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