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Kentucky Hospital Agrees to Pay $16.5 Million to Settle Medicare Fraud Allegations
A Kentucky hospital has agreed to pay $16.5 million to settle allegations that it submitted false claims to the Medicare and Kentucky Medicaid programs for unnecessary cardiac procedures.
Saint Joseph Health System Inc., which operates numerous hospitals statewide, including Saint Joseph Hospital in London, Ky., will pay the settlement to resolve allegations that doctors working at the hospital performed invasive cardiac procedures on Medicare and Medicaid patients who did not need them.
The government alleged that doctors affiliated with Cumberland Clinic, a physician group that entered an exclusive arrangement with Saint Joseph Hospital in 2008, performed medically unnecessary procedures, including coronary stents, pacemakers, and coronary artery bypass graft surgeries.
One of the doctors, Dr. Sandesh Patil, a cardiologist working at the hospital, has pleaded guilty to a federal health care fraud offense and has been sentenced to serve 30 months in prison.
The settlement also resolves allegations that Saint Joseph Hospital violated the federal Stark Law and Anti-Kickback Statute by entering into sham management agreements that financially benefitted two London-based cardiologists, Satyabrata Chatterjee and Ashwini Anand, as an inducement for them to direct more Cumberland Clinic patients to the hospital.
The hospital has agreed to enter into a Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG), which obligates the hospital to undertake substantial internal compliance reforms and to commit to a third-party review of its claims to federal health care programs for the next five years.
The government has also announced its intervention in a lawsuit alleging False Claims Act violations by Chatterjee and Anand, who referred patients for and performed the unnecessary procedures and tests, and their practice group, Cumberland Clinic, as well as the practice groups each of them owned before forming Cumberland Clinic.
Key Facts
- State: Kentucky
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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