Sutter Health, Catholic Health settle $2.3M improper billing claims

Catholic Healthcare West and Sutter Health--two of Sacramento's largest health systems--paid a combined $2.3 million to settle allegations that their affiliated hospitals overbilled Medicare, the U.S. Justice Department announced Wednesday, The Modesto Bee reports.

Although they did not admit wrongdoing, Sutter Health paid $1.43 million, and Catholic Healthcare West paid more than $875,000 for allegedly double billing Medicare for infusion therapies and treatments to break up kidney, bladder, or ureter stones.

"Although we have had bigger settlements with health care systems, this is a significant settlement," Lauren Horwood, a spokeswoman for the U.S. attorney's office, said in an email to The Modesto Bee.

The investigation against Sutter Health and Catholic Healthcare West is part of an increased effort by the Office of the Inspector General to reduce healthcare fraud, abuse, and waste, such as improper billing.
"This office will actively pursue recovery of Medicare dollars," U.S. Attorney Benjamin Wagner said in a statement, The Sacramento Bee reports. He added, "This settlement not only recoups overpayments made by Medicare, it helps ensure more accurate billing practices by these hospital systems in the future."

Among other recent large system settlements are Geisinger for $1.3M for allegedly overbilling Medicare, Columbia University for $1 million to settle Medicare fraud charges against Columbia and New York Presbyterian Hospital, and Cleveland Clinic for $254,000 for alleged inappropriate Medicare claims.

For more information:
- read the Sacramento Bee article
- read the Modesto Bee article
- here's the Sacramento Business Journal article
- read the AP article

Related Articles:
State owes $35M in Medicaid errors
OIG: Medicare overpaid Cleveland Clinic $254k due to poor billing controls
Senate to probe Aetna, Cigna, United Healthcare, Quest, LabCorp for alleged billion-dollar fraud
New York City pays $70M for overbilling Medicaid
Medicare fraud charges settled against NY Presbyterian, Columbia, doc for nearly $1M