Hospital system, doctor to pay $430,000 over fraud

By U.S. Attorney, Oregon District
Press release,

The U.S. Attorney’s Office for the District of Oregon announced today that Asante Health System, a southern Oregon healthcare corporation, and one of its physicians, have agreed to pay $430,000 to settle allegations that the company and its physician knowingly submitted false claims for payment for certain cardiothoracic surgeries to Medicare, Medicaid, and TRICARE.

Between January 1, 2015, and January 31, 2021, Asante and Dr. Charles Carmeci, a cardiothoracic surgeon practicing at Asante Rogue Regional Medical Center, knowingly submitted claims for payment to Medicare, Medicaid, and TRICARE for cardiothoracic surgeries including decortications, PleurX catheter placements, pericardiectomies, mediastinal mass resections, patent foramen ovale, atrial septal defect closures, and Bentall procedures, knowing they did not meet the criteria for reimbursement or were otherwise improper.

Medicare and Medicaid are public health insurance programs administered by the Centers for Medicare & Medicaid Services, a federal agency within the U.S. Department of Health and Human Services (HHS). TRICARE is a civilian health care program administered by the Defense Health Agency (DHA), a joint, integrated combat support agency within the U.S. Department of Defense (DOD).

The settlement reached is not an admission of liability by Asante or Dr. Carmeci and both parties deny the government’s allegations.

This case was investigated by the HHS Office of Inspector General (HHS-OIG), FBI, and DHA. Both agencies were represented in this matter by Alexis Lien, Assistant U.S. Attorney for the District of Oregon. Lisa M. Re, Assistant Inspector General for Legal Affairs for HHS-OIG, and Salvatore M. Maida, General Counsel for DHA assisted in this litigation.

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