Saint Joseph Health system Inc. will pay the government $16.5 million to resolve allegations of Medicare and Medicaid fraud for a variety of unnecessary cardiac procedures.
In a case originally brought by a whistleblower, it is alleged that doctors working at the hospital performed various invasive procedures including coronary stents, pacemakers, coronary artery bypass graft surgeries and diagnostic catheterizations on Medicare and Medicaid patients who did not need them. It was also alleged that the hospital was aware of these unnecessary procedures.
The settlement also ends allegations that the hospital violated the anti kickback laws by entering into sham management agreements that financially benefitted physicians and induced them to send more patients to the hospital
One cardiologist Dr. Sandesh Patil who performed many of the medically unnecessary coronary stents pleaded guilty to a federal health care fraud offense and has been sentenced to 30 months in prison.
The original whistleblower complaint was filed by three cardiologists under the False Claims Act which permits private persons to bring lawsuits on behalf of the government and share in the proceeds. Drs. Michael Jones, Paula Hollingsworth and Michael Rukavina will receive $2.46 million of the $16.5 million settlement.