Sutter Well being pays $13M for allegedly billing feds for exams it didn’t do


(BCN) — Sutter Well being has agreed to pay greater than $13 million to settle allegations it violated the U.S. False Claims Act by billing the federal authorities for toxicology screening exams carried out by outdoors labs.

Federal regulation enforcement officers from varied companies introduced the take care of the Sacramento-based well being care supplier Monday in San Francisco.

“Sutter Well being agreed to pay $13 million to settle allegations that it billed authorities well being packages for lab exams carried out by others,” stated U.S. Legal professional Stephanie M. Hinds, in an announcement. “Authorities well being care packages should be protected, and this workplace will examine and pursue well being care suppliers that fail to supply the providers paid for by public well being care packages.”

Federal authorities stated the civil settlement settlement is “neither an admission of legal responsibility by Sutter Well being nor a concession by the USA that its claims aren’t nicely based.” Sutter Well being didn’t instantly return a request for remark.

The federal government contends in a civil settlement settlement signed by Sutter Well being that beneath the phrases of a contract between Sutter Well being hospital Alta Bates Summit Medical Heart and Navigant Community Alliance, LLC, Navigant referred urine toxicology specimens obtained from physicians and laboratories throughout the nation to Sutter. Sutter allegedly submitted payments, or prompted payments to be submitted, for reimbursement of the qualitative and quantitative testing it carried out on the specimens.

Federal officers say Sutter didn’t carry out the quantitative testing on hundreds of specimens referred to beneath the settlement, and the exams had been as an alternative carried out by third-party labs. The federal government says Sutter nonetheless sought reimbursement for the exams.

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Within the settlement settlement, the federal government says between Aug. 1, 2016, and June 30, 2017, Sutter billed for urine toxicology exams it didn’t carry out, but was paid for the testing by the Federal Staff Well being Advantages Program, Medicare, Medicaid, and Tricare. Of the $13,091,452 Sutter has agreed to pay, the well being care supplier has already paid greater than $6.5 million to the U.S. authorities.

Sutter has agreed to pay the remaining quantity inside 30 days. The settlement is a results of a joint investigation between the U.S. Legal professional’s Workplace for the Northern District of California, the FBI and different authorities companies.

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