CHICAGO (CBS) — A lawsuit has issued severe claims of fraud towards Roseland Group Hospital within the metropolis’s Far South Aspect – centered round COVID-19 testing.
As CBS 2’s Jermont Terry reported Friday evening, a whistleblower accuses the hospital of operating up insurance coverage payments, and raking in hundreds of thousands.
For greater than a 12 months, federal investigators stored paperwork on this case sealed – till Friday. A fired physician whose sole job was to supervise COVID testing, together with a Roseland hospital government, are accused of intentionally defrauding taxpayers and insurance coverage corporations for revenue.
Throughout the peak of the COVID-19 pandemic, well being services scrambled to satisfy the demand for testing. On the Far South Aspect on the time, we noticed individuals standing in lengthy traces at Roseland Group Hospital.
Now, two years later, the whistleblower claims the hospital “billed for companies associated to COVID-19 testing that have been by no means offered.”
The newly-unsealed criticism was filed by Elio Montenegro, who’s an “worker of Roseland the place he works because the Senior Director of Growth.” The whistleblower labored straight with hospital leaders again then, and nonetheless does immediately.
The 25-paghe criticism accuses a now-fired worker – “Dr. Terrill Applewhite, an unbiased contractor, who labored as Medical Director overseeing the hospital’s COVID-19 response.”
The swimsuit says Applewhite and his firm, together with the hospital, “knowingly and deliberately submitted false claims for cost.”
As an alternative of testing just for COVID, the federal swimsuit says insurance coverage corporations and the federal government have been “billed for a “full panel” of blood exams” – leading to pointless costs and payments.
How a lot are we speaking? In response to the criticism, the physician and the hospital “billed for roughly 20,000 to 25,000 sufferers visits,” leading to “between $2.8 and $3.6 million in fraudulent billing.”
The whistleblower stated when he knowledgeable the hospital, the physician was fired. Btu the swimsuit claims,
“Roseland by no means disclosed these false billings to any authorities company or personal insurer.”
And when the whistleblower brough the issues on to hospital executives, the swimsuit claims hospital leaders stated, “it was so Roseland might earn extra earnings.”
However an lawyer for Roseland Group Hospital issued a press release denying that the hospital or its chief government officer, Tim Egan, have been concerned in something improper:
“Mr. Egan and Roseland Hospital share the Relator’s concern with improper third-party billing and companies. Unbeknownst to Mr. Montenegro, for greater than a 12 months, Mr. Egan has been sharing info on a confidential foundation with federal investigators into Dr. Applewhite. Mr. Egan fully denies any insinuation by Mr. Montenegro that he or Roseland Hospital have been concerned in any improper habits.”
The whistleblower didn’t wish to speak on to us in regards to the lawsuit. However Roseland Group Hospital insisted they hid nothing from federal investigators.