Sacramento’s Sutter Health to pay $13 million to settle federal allegations of illegal billing
Sacramento-based Sutter Health agreed to pay roughly $13 million to settle allegations that it illegally billed federal agencies for performing tests that actually had been performed by a third-party laboratory.
“Government health care programs must be protected, and this office will investigate and pursue health care providers that fail to provide the services paid for by public health care programs,” said Stephanie M. Hinds, U.S. Attorney for the Northern District of California.
A Sutter spokeswoman said the company would have no further information to share. In a news release issued on the settlement, the U.S. Attorney noted that the settlement is “neither an admission of liability by Sutter Health nor a concession by the United States that its claims were not well-founded.”
The Sutter agreement settled a civil complaint brought by Medicare; Medicaid; the TRICARE health care program that covers uniformed service members, veterans and their families; and the Federal Employees Health Benefits Program that covers civilian workers in the U.S. government.
The four parties alleged that Alta Bates Summit Medical Center contracted to test urine toxicology specimens obtained from physicians and laboratories across the country, then billed for the work. However, Justice Department said, a third-party lab completed the qualitative testing on thousands of specimens referred between Aug. 1, 2016, and June 30, 2017.
The Sutter billings violated the False Claims Act, the Justice Department said, noting that the public can share tips about potential fraud, waste, abuse, and mismanagement with the Department of Health and Human Services at 800-447-8477.
Sutter has already paid more than $6.5 million of the settlement and will pay the remainder within 30 days, government attorneys said.
Last year, Sutter agreed to pay $90 million to settle other allegations made under the False Claims Act. Medicare alleged the company’s staff and doctors had lied about the seriousness of patient’s conditions in order to inflate how much Sutter should be paid.
This story was originally published October 19, 2022 at 9:38 AM.
