Michigan healthcare provider settles fraud case for nearly $3M.
Ascension Michigan will pay $2.8 million as part of a settlement agreement to resolving claims against a former cancer doctor, Farid Fata, of healthcare fraud. The one-time gynecologic oncologist headed a cancer clinic and “knowingly misdiagnosed or poisoned with cancer treatment more than 550 patients across seven locations,” according to a Department of Justice (DOJ) investigation.
Ascension Michigan is a large hospital chain that has numerous hospitals and outpatient clinics throughout the state. In 2017, more than three dozen patients received $791,047 million from Crittenton Hospital in Rochester Hills (owned by Ascension since October 2015) as part of the malpractice lawsuit. Fata submitted false claims and billed for medically unnecessary treatments in an attempt to maximize profits. He is currently serving a 45-year sentence in federal prison.
False Claims Act (FCA) allegations against Fata and Crittenton were brought by whistleblowers under the qui tam provisions of the act. The FCA imposes liability on persons and companies who defraud governmental programs. The whistleblowers, called ‘relators,’ Pamela Satchwell, Dawn Kasdorf and Bethany Silva-Gomez, were employed as office staff. They began to notice that unnecessary lab tests were being performed and questioned why patients were receiving bills for these services.
Ascension Michigan spokesperson Brian Taylor said at the time of the investigation, “We remain committed to cooperating with the Department of Justice on these matters that occurred prior to Crittenton becoming part of our health system. Our thoughts and prayers continue to be with the patients and their families.”
The government ultimately determined Ascension “improperly retained payment for professional and facility fees related to medically unnecessary radical hysterectomies that the doctor performed, [and] chemotherapy services that the doctor administered or ordered that were not medically necessary.” Ascension at first fought the case against it, but eventually cooperated with the government. The initial case was filed under United States ex rel. Satchwell v. Ascension Health, No. 17-CV-12315 (E.D. Mich.). The relators will receive a combined payment of $532,000 for their role in reporting the fraud.
“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 DOJ’s Civil Division. “We will continue to ensure that taxpayer funds are used appropriately for the important programs that they support.”
U.S. Attorney Saima Mohsin for the Eastern District of Michigan, which collaborated with the DOJ on the resolution, said, “Health care providers cannot avoid their obligation to repay government funds owed to federal health care programs. We will vigorously pursue those who knowingly fail to repay monies they have received based on services which were not medically necessary or not rendered as billed.”