Moultrie Observer

Local News

February 21, 2007

CRMC settles federal fraud case

MOULTRIE — Following a U.S. Department of Justice investigation, Colquitt Regional Medical Center (CRMC) agreed to pay the federal government $475,000 to settle fraud allegations.

The federal whistleblower case, which was filed Aug. 17, 2004, remained sealed until Wednesday. It centered around a series of claims submitted for Medicaid and Medicare reimbursement by CRMC’s Home Care Services office in Sylvester from 2001 to 2005.

Plaintiff Joyce Dickerson, a registered nurse and former director of the Moultrie Home Care Services office, allegedly reported to the hospital administration and the hospital authority in 2004 what she believed to be years of illegal billing. While hospital officials say the settlement was based on an “error rate,” Dickerson’s attorney Robert Howell of Moultrie said in actuality CRMC owes the federal government double the compromise agreement.

In the complaint, CRMC was alleged to have received payment from Medicare for services that were not reasonable and necessary, upcoded certification diagnoses so that the hospital was overpaid by Medicare and underutilized services after being paid in advance by Medicare allowing defendants to receive payment from both Medicare and patients.

During the time of the alleged fraud, defendant Colleen Grimsley of Sylvester had been director of the Sylvester office until 2004 when Dickerson assumed directorship of both offices. Grimsley would have had financial incentive to commit the alleged fraud, Howell said. Revenue was a component of the home health directors’ annual review, he said.

“All she [Dickerson] really wanted to do was to bring this to the attention of the administration and make it stop, because she feared for her own license and she also feared for the organization she worked for,” Howell said. “She brought it to their attention, they didn’t do anything to stop it and so she felt compelled to go to the next level with it, so that’s just what she did.”

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