CoxHealth anticipates Medicare fraud settlement of about $60 million

by Marie Saavedra, KY3 News

CoxHealth anticipates Medicare fraud settlement of about $60 million
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By Gene Hartley

SPRINGFIELD -- CoxHealth Systems says it is closer to ending a Medicare fraud investigation that the FBI and the U.S. attorney’s office have been conducting for more than three years. CoxHealth may be close to reaching a settlement that could cost it $60 million.

The federal government's investigation into CoxHealth Systems focuses on billing practices at one of its clinics but also delved into other areas. Investigators have been trying to prove, or force an admission, that Medicare was overcharged for certain procedures, and was billed for services that some physicians didn’t perform.

CoxHealth has been putting money away for fines, penalties or repayments since it learned about the investigation in late 2004. A settlement is in the works between Cox and the federal government in the neighborhood of 60 million dollars.

In a statement posted on a Web site for investors and stock analysts, CoxHealth says $60 million "is in the range where CoxHealth anticipates we may finally settle. CoxHealth accrued this amount in its financial statements over the last three years."

Financial records for 2005 and 2006 show CoxHealth put away $13 million both years for possible payments related to the case. That would mean, in 2007, CoxHealth had to have put the remaining $34 million aside for legal funds.

The U.S. Attorney's office says general protocol requires, in cases alleging Medicare's fund has been defrauded, settlement money would return to the Medicare fund.

CoxHealth says the negotiations are far from over. No one has publicly said when the two sides might agree on the final amount of a settlement.

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