Palo Alto, CA, January 05, 2021 –(PR.com)– The Ninth Circuit Court of Appeals recently rejected Stanford Healthcare’s (formerly Stanford Hospitals and Clinic) argument in the U.S. government’s case against Stanford Healthcare for nearly $500 million dollars of alleged Medicare billing fraud. In entering its ruling against the healthcare company, the court struck Stanford’s argument on the critical motion.
The Federal False Claims Act Complaint against Stanford Hospital and Stanford Healthcare was filed in December of 2017 in Federal Court. The Complaint alleges Stanford misused its “Epic” electronic records system which allowed Stanford to schematically alter and adulterate health and billing records without detection.
The Complaint alleges: Stanford Hospital executives participated in healthcare fraud which included upcoding and unbundling to obtain payments; Stanford University had a fee-sharing agreement with Stanford Hospital called the “Dean’s tax” slush fund to monetize Stanford Hospital’s new “corridor and arcade” which opened in late 2019; to do so, Stanford executives deputized division chiefs and billing managers, who pressured physician colleagues to submit the maximum level billing codes regardless of controverting medical records and necessity, for more lucrative codes than they were otherwise lawfully entitled.