Claris Law Legal Blogging Community

Editor: Mike Bothwell
Profession: Qui Tam Attorney

Category: Settlements and Verdicts

BlueCross BlueShield of Tennessee (BCBS-T) agreed on August 11, 2008, to pay $2.1 million to the United States to settle allegations that it violated the False Claims Act. Specifically, BCBS-T settled claims that between 2000 and 2002, the Medicare Part A Fiscal intermediary for New Jersey did not adjust cost-to-charge ratios for Hospitals in the state. The result was "outlier payments" by Medicare to those hospitals and facilities. Outlier payments are supplemental reimbursement payments by Medicare to hospitals where the cost for care is high.