Adventist Health Can't Dodge FCA Claim Of ER Overbilling

By Daniel Wilson (February 20, 2013, 12:17 PM EST) -- A Florida federal judge on Tuesday refused to toss two former workers' claim that hospital owner Adventist Health System/Sunbelt Inc. had fraudulently overbilled Medicare, Medicaid and Tricare for emergency department services, ruling the plaintiffs had adequately backed the claim.

According to U.S. District Judge John Antoon II, relator Amanda Dittmann — a former bill-coding and reimbursement compliance officer at the company — was in a position to have personally observed AHS' allegedly unlawful emergency billing practices, meaning the relators had shown the necessary firsthand knowledge of the company's claimed wrongdoing.

"The relators' allegations 'provide the indicia of reliability that is necessary...

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