Lakeland Regional Medical Center Agrees to Pay $4 Million to Settle Allegations of Medicaid Payment Funding

Strategic Insights -

The U.S. Department of Justice's Computer Crime & Intellectual Property Section has announced that Lakeland Regional Medical Center (LRMC) in Lakeland, Florida, has agreed to pay $4 million to resolve allegations that it made donations to a local unit of government to improperly fund the state's share of Medicaid payments. The Florida Medicaid program provides medical assistance to low-income individuals and individuals with disabilities, and is jointly funded by the federal and state governments. LRMC allegedly made improper, non-bona fide donations to Polk County, Florida, between October 2014 and September 2015, by assuming and paying certain of Polk County's financial obligations to other healthcare providers.

Key Takeaways:

  • LRMC agreed to pay $4 million to settle allegations of improperly funding Medicaid payments through non-bona fide donations to Polk County, Florida.
  • The alleged improper donations were made between October 2014 and September 2015, with the goal of increasing Medicaid payments received by LRMC.
  • The Florida Medicaid program is jointly funded by the federal and state governments, and the state's share of Medicaid payments must consist of state or local government funds and may not come from non-bona fide donations from private health care providers.
  • The United States alleged that LRMC's donations were designed to increase Medicaid payments received by LRMC, by freeing up funds for the County to make payments to the State as the state share of Medicaid payments to LRMC.
  • The Medicaid payments LRMC received were funded by the federal government and LRMC's own donations, in violation of the prohibition on non-bona fide donations.
  • LRMC's actions allegedly caused federal expenditures to increase without any corresponding increase in state expenditures, since the state share of Medicaid payments to LRMC came from and was returned to the provider, LRMC.

Statistics:

  • $4 million: The amount LRMC agreed to pay to settle allegations of improperly funding Medicaid payments.
  • October 2014 and September 2015: The time period during which LRMC allegedly made improper, non-bona fide donations to Polk County, Florida.
  • 100%: The percentage of federal expenditures that allegedly increased without any corresponding increase in state expenditures due to LRMC's actions.

Sources:

  • "Florida's Lakeland Regional Medical Center Agrees to Pay $4 Million to Settle Common Law Allegations" - A press release from the U.S. Department of Justice's Computer Crime & Intellectual Property Section.
  • (https://www.justice.gov/opa/pr/florida-s-lakeland-regional-medical-center-agrees-pay-4-million-settle-common-law-allegations)