(Deming) – Deming’s Mimbres Memorial Hospital is one of three New Mexico hospitals and the hospitals’ parent company that have agreed to pay the United States $75 million to settle allegations that they violated the False Claims Act.
The U.S. Justice Department announced Monday that the charges stem from the hospitals making illegal donations to county governments which were then used to fund the state share of Medicaid payments to the hospitals.
New Mexico’s Sole Community Provider program, which was discontinued last year, provided supplemental Medicaid funds to hospitals in mostly rural communities. The federal government reimbursed the state for approximately 75% of its health care expenditures under the program.
Under federal law, New Mexico’s 25% “matching” share of Sole Community Provider program payments had to consist of state or county funds, and not impermissible “donations” from private hospitals. This restriction reportedly was enacted by Congress to curb possible abuses and ensure that states had sufficient incentive to curb rising Medicaid costs.
The United States alleged that from August 1st, 2000, through December 31st, 2010, Community Health Systems knowingly caused the state to present false claims to the federal government for payments made to CHS under the Sole Community Provider program by making improper donations to Luna and two other counties, which were then used by the counties, and subsequently the state, to obtain federal matching payments.
The government alleged that CHS concealed the true nature of these donations to avoid detection by federal and state authorities, and as a result of its scheme, received payments from the federal government in the amount of three times CHS’ “donations.”
Named in the suit in addition to Community Health Systems Professional Services Corporation and Mimbres Memorial Hospital in Luna County were Eastern New Mexico Medical Center in Chaves County and Alta Vista Regional Medical Center in San Miguel County.
The U.S. Justice Department announced Monday that the charges stem from the hospitals making illegal donations to county governments which were then used to fund the state share of Medicaid payments to the hospitals.
New Mexico’s Sole Community Provider program, which was discontinued last year, provided supplemental Medicaid funds to hospitals in mostly rural communities. The federal government reimbursed the state for approximately 75% of its health care expenditures under the program.
Under federal law, New Mexico’s 25% “matching” share of Sole Community Provider program payments had to consist of state or county funds, and not impermissible “donations” from private hospitals. This restriction reportedly was enacted by Congress to curb possible abuses and ensure that states had sufficient incentive to curb rising Medicaid costs.
The United States alleged that from August 1st, 2000, through December 31st, 2010, Community Health Systems knowingly caused the state to present false claims to the federal government for payments made to CHS under the Sole Community Provider program by making improper donations to Luna and two other counties, which were then used by the counties, and subsequently the state, to obtain federal matching payments.
The government alleged that CHS concealed the true nature of these donations to avoid detection by federal and state authorities, and as a result of its scheme, received payments from the federal government in the amount of three times CHS’ “donations.”
Named in the suit in addition to Community Health Systems Professional Services Corporation and Mimbres Memorial Hospital in Luna County were Eastern New Mexico Medical Center in Chaves County and Alta Vista Regional Medical Center in San Miguel County.
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