November 15, 2019
California healthcare system
Sutter Health, its hospital the
Sutter Memorial Center Sacramento, and the
Sacramento Cardiovascular Surgeons Medical Group, Inc., will pay a total of
$43.12 million to resolve allegations that the entities violated the Stark Law and improperly double-billed Medicare. Specifically, Sutter Memorial will pay $30.5 million to resolve charges of wrongfully billing Medicare for services referred to the hospital by Sac Cardio, with whom the hospital maintained improper financial arrangements that overcompensated the Sac Cardio physicians. In addition, Sutter will pay $15.12 million to resolve allegations that it paid physicians compensation at rates that exceeded fair market value, leased office space to them at below-market rates, and reimbursed them for expenses at inflated rates. In addition to the Stark Law violations, the settlement also resolved allegations that Sac Cardio submitted duplicative bills for physician assistant services (Sac Cardio will pay $500,000 to resolve these claims), and allegations that several Sutter ambulatory surgical centers had double-billed Medicare for radiological services that had actually been provided, and billed for, by a separate entity. DOJ reported that allegations against Sutter Memorial and Sac Cardio were first made in a
qui tam lawsuit brought by
Laurie Hanvey, who will receive
$5.9 million from the settlement, and that Sutter Health self-disclosed other conduct at issue in the settlement.
DOJ;
USAO ED Cal;
USAO ND Cal