Emory University will pay $1.5 million to settle federal and state claims that it violated the False Claims Act by improperly billing Medicare and Medicaid for clinical trial services at its Winship Cancer Institute.
The U.S. Justice Department and the Georgia attorney general’s office made the announcement Wednesday in the civil case, which resulted from a whistle-blower lawsuit filed by a former Emory employee, Elizabeth Elliott.
Government officials alleged Emory billed Medicare and Medicaid for services that the sponsor of the clinical trial agreed to pay. In some cases, the sponsor did pay, the government said, so Emory was paid twice for the same service.
“Our investigation of Emory University revealed the institution’s clinical trial false billing and led to today’s settlement. Protecting Medicare — and taxpayer dollars — remains a top priority,” said Derrick Jackson, special agent in charge of the U.S. Department of Health and Human Services, Office of the Inspector General for the Atlanta region.
In a statement, Emory said: “Between 2010-13, Emory cooperated with the U.S. Attorney’s Office for the Northern District of Georgia regarding an investigation of billings related to oncology trials at the Winship Cancer Institute between 2001-10. While Emory acknowledges billing errors occurred over the ten-year period, Emory’s agreeing to settle this matter is in no way an agreement or admission that the university has any liability under the False Claims Act.”
Emory added that, “the billing process for oncology trials is extremely complex for two major reasons: the intricacies of federal regulations; and the fact that oncology patients enrolled in trials generally receive a high volume of services, most of which are not related to the clinical research so that certain services must be separated out from the usual billing process.”
U.S. Attorney Sally Quillian Yates said the settlement demonstrates the government’s commitment to guard federal dollars. “Treatment of cancer is expensive,” she said, “and Medicare and Medicaid dollars should be reserved for patients who need services that properly may be billed to these programs.”
Mike Bothwell, an attorney for Elliott, said he could not comment on the settlement, according to terms of the deal.
Elliott, who filed her complaint in 2009, could not be reached. She had been a clinical research finance manager at Emory. According to the settlement, Emory will pay Elliott $322,500 for expenses, attorney’s fees and costs, plus $11,250 for wrongful termination claims.