New Jersey Hospital and Investors to Pay $30.6 Million for Alleged Medicare Fraud

According to the Department of Justice, from 2018 to 2023, Silver Lake Hospital overbilled Medicare for in-patient services under the so-called “cost outlier” program, designed to incentivize and compensate hospitals for treating patients with unusually expensive care, in violation of the federal False Claims Act. Silver Lake allegedly defrauded the cost outlier payment system by rapidly increasing its charges far more than actual increases in its costs for providing care, thereby receiving excessive payments from Medicare. The Department of Justice further alleged that Silver Lake Hospital transferred millions of dollars to its investors without receiving equivalent value in return, when the hospital knew or should have known that it would not be able to repay its debts to Medicare, in violation of the FDCPA.

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