Massachusetts Attorney General Martha Coakley and US Attorney Michael Sullivan have reached a settlement with Boston Medical Centerand its affiliate, East Boston Neighborhood Health Center, after the health centers were found to have overbilled what’s called the Free Care Pool. The Health Safety Net Trust Fund, commonly referred to as the Free Care Pool, provides reimbursements to acute care hospitals to cover the treatment of patients who are uninsured or underinsured. It is funded in part by the state and federal government.

The attorney general’s office began an investigation in December 2003 after allegations that the health centers submitted inappropriate charges for reimbursement. The charges submitted were for services rendered by the Urgent Care Department of EBNHC, which is open 24 hours a day, seven days a week. But the investigation found that the charges were for services by providers who are not open around the clock.

Boston Medical Center Boston Medical Center is a partner with East Boston Neighborhood Health Center in meeting the community’s health care needs. BMC is committed to compliance with all government payor rules and regulations. BMC, having admitted no liability in the matter, agreed to the settlement to avoid the uncertainty, inconvenience and expense of protracted litigation.

Boston Medical Center said in a statement, “Boston Medical Center is a partner with East Boston Neighborhood Health Center in meeting the community’s health care needs. BMC is committed to compliance with all government payor rules and regulations. BMC, having admitted no liability in the matter, agreed to the settlement to avoid the uncertainty, inconvenience and expense of protracted litigation.”

Boston Medical Center and East Boston Neighborhood Health Center also have agreed to enter into discussions with the Massachusetts Department of Public Health regarding the standards for operation in the Urgent Care Department of Public Health. 

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