Saturday, January 17, 2015

Adventist hospital to pay $2.25M to settle false claims allegations

Adventist hospital to pay $2.25M to settle false claims allegations

Sacramento Business Journal | December 23, 2014

St. Helena Hospital has agreed to pay $2.25 million to settle allegations that it performed unnecessary cardiac intervention procedures and overcharged Medicare.

The 181-bed hospital is affiliated with Roseville-based Adventist Health.

Announced Friday, the settlement resolves whistleblower allegations that the hospital charged Medicare for medically unnecessary angioplasty procedures on patients between January 2008 and July 2011 and unnecessarily admitted them to the hospital when they should have been treated on a less-costly outpatient basis. The procedures open narrowed or blocked blood vessels that supply blood to the heart.

The whistleblower lawsuit was filed in U.S. District Court by Kacie Carroll, a former emergency room director at the hospital who will receive $450,000 for bringing the matter to federal attention. The case was handled by the U.S. Attorney's Office for the Northern District of California.

St. Helena officials said in a statement that they cooperated with the investigation and settled the case without admitting wrongdoing in order to avoid lengthy and costly litigation.

"Our goal is to continue our focus and concerted efforts on serving our community," the statement reads. "We are pleased the matter is concluded."