Penn State Health to Pay $11.7M in Settlement over Improper Medicare Billing

Penn State Health has agreed to pay $11.7 million to resolve civil liability for violating Medicare rules and regulations, the U.S. Department of Justice announced on Wednesday.

The multi-hospital health system discovered and voluntarily reported that between December 2015 and November 2022 it improperly submitted claims Annual Wellness Visit services that were not supported by the medical record.

“Penn State Health’s Compliance Office discovered a discrepancy with regard to documentation requirements for Medicare Annual Wellness Visits,” according to Penn State Health. “After discovering these documentation errors, Penn State Health voluntarily disclosed them to the United States Attorney’s Office,”

The Department of Health and Human Services, Office of Counsel to the Inspector General and Assistant U.S. Attorney Tamara Haken worked with Penn State Health to settle the case.

It’s the second time in less than a year that Penn State Health has agreed to a settlement over self-reported violations of Medicare rules.

In March 2023, the health system agreed to pay $1.25 million after it discovered Hershey Medical Center and St. Joseph Medical Center improperly submitted claims to Medicare Part B for Evaluation & Management services. Penn State Health said at the time it found “documentation was not aligned with Medicare’s technical billing requirements,” and that the services at issue “were medically necessary and were correctly furnished to patients.”