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Friday, November 15, 2024

St.Peter's Health settles $10M over false claims act violations

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U.S. Attorney Jesse A. Laslovich | U.S. Department of Justice

U.S. Attorney Jesse A. Laslovich | U.S. Department of Justice

U.S. Attorney for the District of Montana, Jesse Laslovich, announced a settlement agreement between the federal government and St. Peter’s Health in Helena. St. Peter’s will pay $10,844,201 to resolve allegations of violating the False Claims Act by submitting false claims for payments to federal health care programs for services performed by an oncology doctor.

Laslovich disclosed the settlement during a press conference at the U.S. Attorney’s Office in the Paul G. Hatfield Federal Courthouse in Helena.

“One of the purposes of the False Claims Act is to protect the American taxpayer from paying for false claims submitted by health care providers to federal health care programs. We take these allegations seriously, which is why I am pleased we obtained this settlement agreement that returns almost $11 million to the United States. Our health care providers simply must submit accurate claims when billing these taxpayer-supported federal health care programs for services. This settlement would not have been possible without the cooperation of St. Peter’s Health, who voluntarily disclosed the misconduct and cooperated with federal investigators to identify the problem and amount of false billing,” Laslovich stated.

“Today’s settlement highlights our unwavering commitment to enforcing the False Claims Act and upholding the integrity of federal health care programs,” said Special Agent in Charge Linda T. Hanley, of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “St. Peter’s submission of false claims and its associated compensation practices violated both legal and ethical standards. We will continue collaborating with our law enforcement partners to hold entities accountable, prevent similar violations, and safeguard public funds.”

“VA’s Community Care programs provide veterans and their families critical healthcare services from providers within their own communities,” said Special Agent in Charge Dimitriana Nikolov, of the Department of Veterans Affairs Office of Inspector General’s Northwest Field Office. “This civil settlement reinforces VA OIG’s commitment to safeguarding the integrity of VA’s healthcare programs and operations and preserving taxpayer funds.”

The agreement was signed on August 26, 2024, involving multiple agencies including Medicare and Medicaid programs; TRICARE program; Federal Employees Health Benefits Program (FEHBP); U.S. Department of Veterans Affairs (VA); Office of Inspector General of Railroad Retirement Board (RRB), along with St. Peter's Health.

Under its terms, St. Peter's is required to pay $10,844,201 within 30 days after its effective date.

The government alleged that between January 1, 2015, and December 31, 2020, Dr. Thomas Weiner's documentation led St. Peter's to submit claims that were falsely coded or did not meet service requirements on chemotherapy administration days while compensating him based on these false claims.

The agreement credits St. Peter's for voluntarily disclosing misconduct through internal investigations beyond existing business practices or legal requirements; identifying knowledgeable individuals; making officers available for interviews; assisting in loss determination due to misconduct; enhancing corporate compliance programs.

The matter was handled by U.S Attorney's Office with investigative support from HHS-OIG and VA OIG.

The resolved claims are allegations only with no determination of liability made.

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