Dignity Health, Neurosurgical Associates Pay $10 Million In Billing Fraud Settlement
A major Phoenix hospital is paying $10 million to settle a federal court lawsuit that alleged neurosurgeons were misleading patients and submitting false claims to Medicare.
The plaintiff in the 2018 lawsuit claimed Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center defrauded Medicare and other government health plans in billing for some surgeries. The whistleblowing doctor alleged experienced surgeons had been scheduling procedures for multiple patients at the same time, but he said the surgeries were actually performed by inexperienced residents. The complaint said documents submitted to government health agencies for payment misrepresented information about the surgeries.
“We expect health care providers participating in Medicare to bill for their services accurately and honestly,” acting U.S. Attorney Glenn McCormick said in a press release. “Proper billing ensures fair compensation and protects Medicare dollars that are much needed for patient care.”
Dignity Health and Neurosurgical Associates, LTD, a corporation that operates on the St. Joseph's Hospital campus, paid to settle the case. The U.S. Attorney's Office said the settlement is neither an admission of liability or a concession that the claims are not well founded.
In a statement, Dignity Health said, "Dignity Health St. Joseph’s Hospital and Medical Center has reached an agreement with the Department of Justice to resolve a documentation and billing matter involving compliance and billing requirements set forth by the Centers for Medicare and Medicaid Services (CMS) for overlapping surgeries. The settlement resolves a lawsuit filed in June 2018. The Department of Justice claims are strictly allegations and the settlement by St. Joseph’s is not an admission of liability. St. Joseph’s remains committed to complying with all CMS regulations. St. Joseph’s Barrow Neurological Institute is a world-renowned medical center that cares for patients from throughout the world with the most complex neurological conditions. The Institute provides its patients with safe and high quality care and remains committed to compliance with applicable regulations."
EDITOR'S NOTE: This story has been updated with a statement from Dignity Health.