UCHealth to pay $23 million to settle federal lawsuit over billing fraud allegations

Katie Langford, The Denver Post on Nov 13, 2024

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DENVER — UCHealth will pay $23 million to settle a federal lawsuit alleging the hospital system fraudulently coded emergency room visits submitted to Medicare and the military health insurance program TRICARE.

Department of Justice officials accused UCHealth of using an “automatic coding rule” for ER patients despite knowing the practice didn’t comply with Medicare and TRICARE billing rules, according to a Tuesday news release about the settlement.

UCHealth officials deny the allegations and agreed to settle to avoid long and expensive litigation, spokesperson Dan Weaver said in a statement.

“UCHealth is pleased to see the end of this lengthy and resource-intensive investigation,” Weaver said. “…The settlement allows us to focus our resources on providing excellent patient care.”

In a statement, acting U.S. Attorney for the District of Colorado Matt Kirsch said fraudulent billing undermines healthcare programs that are vital to many Coloradans.

“We will hold accountable healthcare companies who adopt automatic coding practices that lead to unnecessary and improper billing,” Kirsch said.

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