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DOJ Catch of the Week -- Bon Secours Health System

Posted  April 22, 2016

By the C|C Whistleblower Lawyer Team

This week’s Department of Justice “Catch of the Week” goes to Maryland-based Bon Secours Health System and one of its surgical oncologists, Dr. Eugene Chang.  On Monday, they agreed to pay $400,000 to settle charges of violating the False Claims Act by billing Medicare and other federal healthcare programs for non-covered breast examinations and ultrasounds.  See DOJ Press Release.

According to the government, Dr. Chang falsified diagnosis codes to obtain reimbursement for non-covered procedures.  Specifically, for routine screening mammograms, he allegedly assigned a “diagnostic” code that requires a chief complaint from the patient where the actual patient medical charts reflected no such complaint.  The government further charged Dr. Chang with improperly billing as “diagnostic” screening breast examinations and screening breast ultrasounds he arranged for certain patients at approximately six-month intervals following screening mammograms.

The allegations originated in a whistleblower lawsuit filed by a former Bon Secours practice manager and a former colleague of Dr. Chang under the qui tam provisions of the False Claims Act.  They will receive a whistleblower award of $108,000 out of the proceeds of the government’s recovery.  They alleged that Bon Secours’ management had specific knowledge of Dr. Chang’s activities after they alerted Bon Secours to the problem several years ago.

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