Healthcare billing fraud: 8 recent lawsuits, settlements

From Sutter Health paying $90 million to resolve false claims allegations to a cardiologist receiving a prison sentence for his role in a "fountain of youth" billing scam, here are eight cases that have made headlines since Aug. 1.

Editor's note: This is not an exhaustive list. 

1. Feds file false claims suit against UPMC
The U.S. Justice Department has filed a False Claims Act complaint against Pittsburgh-based UPMC, its physician practice group and the chair of its department of cardiothoracic surgery.  

2. Sutter Health to pay $90M to resolve false claims allegations days after reaching antitrust settlement
Sacramento, Calif.-based Sutter Health and several of its affiliates will pay $90 million to resolve allegations that they violated the False Claims Act by submitting inaccurate information about Medicare Advantage beneficiaries, the Justice Department said Aug. 30.

3. Texas hospital to settle allegations of upcoding
John Peter Smith Hospital in Fort Worth, Texas, agreed to settle allegations that it upcoded healthcare claims submitted to federal programs, the Department of Justice said Aug. 27.

4. Telemedicine company owner indicted in $784M fraud scheme
A Florida owner of several telemedicine companies was indicted Aug. 10 on charges that he orchestrated a scheme involving the submission of over $784 million in fraudulent claims to Medicare, according to the U.S. Justice Department. 

5. Sentara to pay $4.3M to settle allegations of submitting improper claims
Norfolk, Va.-based Sentara Healthcare agreed to pay more than $4.3 million to settle allegations that it submitted improper claims in violation of the Civil Monetary Penalties Law, according to HHS' Office of the Inspector General. 

6. California hospital to pay $11.4M, settle whistleblower allegations
San Mateo (Calif.) Medical Center will pay $11.4 million to resolve allegations of improperly submitting claims for inpatient admissions, the U.S. Justice Department said Aug. 6.

7. Ascension Michigan settles with feds over alleged unnecessary chemo, hysterectomies
Ascension Michigan has agreed to pay the federal government $2.8 million to resolve false claims allegations, the U.S. Justice Department announced Aug. 5. 

8. Cardiologist gets 6+ years in prison for 'fountain of youth' billing scam
A cardiologist was sentenced to 6 1/2 years in prison Aug. 5 for his role in a fraud scheme involving more than $13 million in false insurance claims.

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