Hamilton Health Center Agrees To Settlement Of Federal Civil Matter

HARRISBURG – The United States Attorney’s Office for the Middle District of Pennsylvania announced that Hamilton Health Center, Inc., a federally qualified health center in Harrisburg, Pennsylvania, has agreed to pay the United States $270,000 to settle False Claims Act allegations. The settlement results from a self-disclosure by Hamilton to the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) through the OIG’s Provider Self-Disclosure Protocol.

Federal law prohibits Medicare and Medicaid from paying for any item or service rendered by an individual excluded from participation in those programs. According to the self-disclosure and the investigation that followed, from 2006 to 2013, Hamilton allegedly employed an individual who had been previously excluded from participation in Medicare and Medicaid.  The United States alleged that it had civil claims against Hamilton resulting from Medicare and Medicaid payments it received during that period of time that reimbursed the company for the excluded individual’s services. Hamilton has since taken corrective action and voluntarily disclosed the matter. This settlement resolves the matter without the filing of litigation.

HHS OIG has the authority to “exclude” persons or businesses that engage in certain misconduct from participation in Medicare, Medicaid, and other federal healthcare programs.  The effect of exclusion is that no federal program payment may be made for items or services provided by the excluded person/business, or provided because the excluded person prescribed or directed the item or service.  The prohibited items or services goes beyond direct patient care and include such things as administrative and management services.  If a person or business knows or should know that a claim may be submitted to one of the federal healthcare programs that covers one of these prohibited items or services, it exposes itself to liability.

The matter was investigated by the United States Attorney’s Office for the Middle District of Pennsylvania and the Office of Inspector General of the U.S. Department of Health and Human Services. The matter was handled by Assistant United States Attorney Anthony D. Scicchitano for the United States Attorney’s Office.

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