WakeMed pays $8M settlement to Medicare


WakeMed officials said the $8 million settlement stemmed from patients being classified as an inpatient instead of an outpatient without an appropriate physician order. The errors occurred between 2003 and 2010.

Hospital officials said none of the billing issues impacted patient care.

"WakeMed is one of the best hospital systems in the country and is an organization with great integrity. This settlement agreement is the result of billing errors made interpreting Medicare rules and regulations," said WakeMed Board of Directors Chairman Tom Oxholm. "We take full responsibility for the mistakes and regret that errors were made."

In a statement, WakeMed also said it has put in place numerous remedial measures to ensure compliance.

"We always strive to submit accurate, compliant bills to patients, insurance companies, Medicaid, and Medicare," said WakeMed President and CEO Dr. Bill Atkinson. "This process has encouraged us to review our processes and procedures and build additional checks and balances to ensure that we are submitting the most accurate billing information in compliance with all rules and regulations."

The settlement agreement includes a two-year deferred prosecution agreement and a five-year corporate integrity agreement.

"This case will serve as a reminder that hospitals, just like individual health care providers, will be held accountable for their actions. Medicare is a program that relies upon its providers to only bill for services that are actually provided," said United States Attorney Thomas Walker. "Unfortunately, that system of trust carries with it the inherent potential for abuse. This office, along with the United States Department of Health and Human Services, will continue to monitor this matter over the coming years to ensure that the conduct that was the subject of this investigation does not occur again."

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