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.
The settlement resolves allegations that Ascension Michigan, part of St. Louis-based Ascension, and its hospitals submitted false claims to federal healthcare programs for unnecessary chemotherapy and hysterectomies performed by a gynecologic oncologist. The government alleged the false claims were submitted from Feb. 1, 2011, through June 30, 2017.
Though the health system initially kept the funds it collected related to the improper billings, it later disclosed the issue to the federal government, the Justice Department said. Ascension Michigan cooperated with the government's investigation and took several steps to address concerns, including hiring a third-party physician to conduct a peer review and ending its contract with the unnamed physician who performed the unnecessary procedures.
Ascension Michigan was first alerted to a potential problem by patient complaints and the physician's higher than average rates of surgical infections. Because of these concerns, the system had a third-party physician conduct a peer review of a sample of the physician's patients. The review found that a less aggressive surgery or medical intervention would have been the standard of care for the majority of the radical hysterectomies and chemotherapy performed by the physician, according to the Justice Department.
"Ascension Michigan is committed to providing safe, appropriate, quality care to the patients we serve," the system said in an Aug. 6 statement to Becker's Hospital Review. "We proactively reported this matter through the Provider Self-Disclosure Protocol of the US Department of Health and Human Services, Office of Inspector General and cooperated fully with investigators. Applicable medical record documentation processes have undergone comprehensive review."