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Loma Linda doctors settle billing fraud case

A group of faculty practice corporations affiliated with Loma Linda University has paid the United States $2.2 million to resolve allegations that they submitted false claims to Medicare. At teaching hospitals such as Loma Linda, Medicare rules allow reimbursement for services performed directly by the clinical faculty or by residents and interns under their direct supervision. Investigators found that their was insufficient evidence that faculty members were directly involved in performing some of the services billed for. In addition, investigators found evidence of “upcoding,” the practice of submitting claims for greater levels of service than were actually provided.

The U.S. Attorney’s Office in Los Angeles released a press release on November 30, 2004.

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