A Texas federal judge dismissed a False Claims Act lawsuit alleging Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims, according to Law360.
The whistleblower lawsuit, filed in 2017, alleges Baylor Scott & White Health submitted more than $61.8 million in false claims to Medicare over a seven-year period. The allegations in the case focused on two secondary diagnosis codes: “complication or comorbidity” and “major complication or comorbidity.”
The whistleblower alleged Baylor Scott & White’s medical director for coding and utilization spearheaded the alleged scheme to overbill Medicare. He allegedly enacted a scheme to increase the number of patients whose services were coded for CCs and MCCs.
U.S. District Judge David Ezra dismissed the lawsuit because the whistleblower failed to properly state a claim for relief.