Strategic Reimbursement, Inc. Files Lawsuit Against HCA Inc.
Complaint Seeks Damages Resulting From Refusal To Honor Contract After SRI Identified Tens of Millions in Medicare Cost Report SavingsRolling Meadows, IL (October 30, 2006) - Strategic Reimbursement, Inc.(SRI), today filed a court action against health care giant, HCA, Inc. (NYSE: HCA) seeking payment for contracted services that generated tens of millions of dollars of additional Medicare reimbursement for HCA.
Over a six year period, SRI performed an extensive review of HCA's Medicare Cost Reports which identified over $31 million of additional Medicare reimbursement that the federal government owed HCA, Inc. SRI reviewed hundreds of Cost Reports covering multiple fiscal years at dozens of HCA hospitals across the country. Per agreements with HCA, SRI is owed over $7.8 million for this work.
In addition to the $31 million of additional reimbursement generated, SRI's complaint alleges that HCA utilized SRI's work product to disprove the claims filed in the years 1998 - 1999 by the Federal Government that HCA had engaged in systematic abuse and fraud of the Medicare and Medicaid programs. SRI's workpapers and files were requested and reviewed extensively by both the Federal Government and HCA. SRI alleges that HCA utilized the SRI work product to assist in settling the Federal Government's nearly $1,000,000,000 claim for the alleged systemic fraud for a far less significant sum of approximately $250 million. Therefore, SRI should be entitled to 25% of these savings generated.
Despite the fact that the additional $31 million in reimbursement was approved (i.e. "settled") by the relevant Medicare intermediary and the final settlement of the government's claim was substantially less than originally sought, HCA has continually refused to pay SRI anything due to its assertion that no additional "monies" were "actually" ever received by HCA. Per its complaint, SRI is alleging damages ranging from $7.8 million to approximately $200 million.
SRI's complaint also alleges consumer fraud under the Illinois Consumer Fraud Act in that HCA's conduct in refusing to pay for six years of SRI's auditing and consulting services despite the fact that it received huge monetary benefits from this work amounted to deceptive and unfair practices under the Consumer Fraud Act for which SRI should receive damages, punitive damages and its' attorneys' fees.
According to Robert Gienko Sr, Chairman and CEO of SRI: "We did not want it to come to this. I donÕt know how many phone calls I made and letters I wrote over the past few years to the folks at HCA, all to no avail. They simply gave me no other choice."
The action has been filed in the Circuit Court of Cook County, Illinois, and is entitled "Strategic Reimbursement, Inc., as SuccessorŠIn-Interest to Strategic Reimbursement Services, Inc, Plaintiff v. HCA, Inc., f/k/a Hospital Corporation of America, Defendant."
About SRIStrategic Reimbursement, Inc. is a financial and third party consulting firm focused exclusively on third party compliance, reimbursement and revenue enhancement for hospitals and other healthcare providers across the country. Founded in 1975, SRI has assisted over 400 hospitals and systems with their most serious reimbursement issues with a variety of payers including Medicare, Medicaid, managed care and Tricare / CHAMPUS. It has particular expertise with Medicare / Medicaid Cost Report preparation / review, DSH calculations, Wage Index reviews, Medicare Bad Debt Log preparation, and Illinois Blue Cross managed care payment reviews.
For more information, please contact: Robert Gienko, Sr.President
Strategic Reimbursement, Inc
847-259-7373 x106
Tim Hoffman
Lead Attorney
Sanchez Daniels & Hoffman Attorneys and Counselors
312-641-1555
