EDITOR'S NOTE: The latest settlement did not state the name of the doctor involved and was sealed. This story has been updated to identify Dr. Farid Fata as a hematologist-oncologist, who is involved with another, separate case.
Ascension Michigan and its related hospitals will pay $2.8 million in a settlement to resolve claims alleging healthcare fraud.
The settlement, announced Thursday, is meant to address legal allegations that for a period of six years from 2011, the provider knowingly submitted false payment claims to the federal government and billed for medically unnecessary treatments. There has been no determination of liability, and the name of the doctor involved in the case has not been publicly disclosed.
“When hospitals receive payment from federal health care programs for medically unnecessary surgical procedures, they cannot simply retain those payments; they have an obligation to return them,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division in a statement. “We will continue to ensure that taxpayer funds are used appropriately for the important programs that they support.”
Ascension had previously settled claims relating to hematologist-oncologist Farid Fata, who ran a cancer treatment clinic and purposefully misdiagnosed or poisoned with cancer treatment more than 550 patients across seven locations through his practice. In 2016, more than three dozen patients won an $8 million settlement in a malpractice suit against Fata, which involved one of Ascension Michigan’s hospitals and two other providers. Fata is serving a 45-year sentence in federal prison.
Then, in 2017, Ascension agreed to pay $791,047 to settle claims that Crittenton Hospital had billed for medically unnecessary lab tests for patients referred by Fata’s office. Though Ascension initially kept the funds it received, it eventually cooperated with the government and voluntarily disclosed the fraud that occurred.
In the DOJ’s announcement Thursday, acting U.S. Attorney Saima Mohsin for the Eastern District of Michigan, which collaborated with the DOJ on the resolution, said, “We will vigorously pursue those who knowingly fail to repay monies they have received based on services that were not medically necessary or not rendered as billed.”
Healthcare comprises the vast majority of cases pursued by the DOJ under the False Claims Act. During 2020’s fiscal year alone, $1.8 billion of the $2.2 billion recovered by the department under the False Claims Act involved healthcare fraud and false claims.
During that same year, $1.6 billion of the total settlements arose from lawsuits filed under the act’s whistleblower provisions. Those individuals received a collective payout of $309 million during fiscal year 2020.