July 18, 2006 Marion County Medical Center
Marion County Medical Center in Marion County S.C. has agreed to pay $3.75 Million Dollars to resolve allegations raised by Dr. Kenneth Orback, a former employee of the Medical Center. The allegations of the case were that the Medical Center submitted false claims to Medicare, Medicaid and TRICARE, and violated both the Stark Law and a federal Anti-Kickback Statute.
The allegations included claims that the Medical Center caused Medicaid, Medicare and/or TRICARE to pay physicians compensation which far exceeded the value of the services which had been provided.
The case also included allegations that the Medical Center had engaged in “upcoding.” Upcoding is an practice within which a medical provider provides one type of service, but then bills Medicaid or Medicare for a more expensive service than the one provided, by putting a different billing code on claim forms which the provider submits to Medicaid, Medicare or TRICARE.
As part of a settlement, Dr. Orback is to receive $610,000 for having filed the qui tam action
See U.S. Dept of Justice Press Release 7/18/06