Contracted physicians at Ascension All Saints accused of overbilling Medicare, Medicaid

A physician filed a federal whistle-blower lawsuit against TeamHealth, the contracted anesthesiology group at Ascension All Saints Hospital in Racine, Wis., alleging the hospital staffing firm overbilled Medicare and Medicaid millions through its subsidiary Racine Anesthesia Services, The Journal Times reported.

John Mamalakis, MD, an anesthesiologist, filed the False Claims Act case in 2014 in the U.S. District Court for the Eastern District of Wisconsin. In the case, Dr. Mamalakis claims he lost his job because he refused to be part of the alleged overbilling, the report states. The lawsuit claims the overbilling occurred from 2011 to at least 2014 and involved overcharging Medicare and insurance programs in 16 states and Washington, D.C. According to The Journal Times, Dr. Mamalakis alleges TeamHealth continues fraudulent billing practices at All Saints and other hospital locations.

TeamHealth told Becker's the Department of Justice considered the allegations but decided not to look into the issue further. The firm declined to comment on specifics of the case since it is still pending litigation.

TeamHealth said it "has a robust and long-standing compliance and ethics program, which incorporates the components recommended by the Office of Inspector General compliance program guidance, including a chief compliance officer, policies and procedures, a code of conduct, initial and annual compliance training, internal auditing and monitoring, and a compliance hotline."

"As a matter of protocol, all compliance-related inquiries are taken seriously and investigated," the firm said.

An Ascension Wisconsin spokesperson also declined to comment on specifics of the case, saying, "We take compliance and patient care issues seriously. This lawsuit is between TeamHealth and one of their former employees. Therefore, we cannot comment further."

Dr. Mamalakis specifically alleges in his complaint that while he was at All Saints, TeamHealth physicians falsified records by claiming they were present or available to All Saints operating rooms when they were not.

"In some instances, the absence of the TeamHealth anesthesiologists at All Saints' operating rooms and ICUs [intensive care units] has placed the patients' lives at unnecessary risk," his complaint states, according to the report.

The case is ongoing in federal court.

Access the full report from The Journal Times here.

Editor's note: This article was updated on Oct. 24. 

 

More articles on legal and regulatory issues:

Texas hospital co-founder admits bribing physicians as part of $200M billing scheme
Kentucky hospital's ex-chief of staff fails to halt $361M sale to Baptist Health
Hospital management company CEO wants money, property released amid investigation

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Featured Webinars

Featured Whitepapers