Oregon health system, cardiothoracic surgeon agree to pay $430K to settle fraud allegations
Asante Health System, a large health system serving southern Oregon and northern California, and one of its cardiothoracic surgeons have agreed to pay $430,000 to settle allegations they submitted false claims to multiple government-funded health insurance programs.
According to the U.S. government, Asante Health System and Charles Carmeci, MD, knowingly submitted false claims to Medicare, Medicaid and TRICARE for multiple cardiothoracic surgeries from Jan. 1, 2015, to Jan. 31, 2021. These claims were allegedly submitted even though “they did not meet the criteria for reimbursement or were otherwise improper.”
Surgeries that were part of the alleged scheme included decortications, PleurX catheter placements, pericardiectomies, mediastinal mass resections, patent foramen ovale, atrial septal defect closures and Bentall procedures.”
The U.S. Attorney’s Office for the District of Oregon announced the settlement Tuesday, Jan. 16, noting that it does not represent an admission of liability or guilt. Both the health system and Carmeci still deny the allegations.
The Lund Report, a Portland-based online news source, received word of this settlement days before it was officially announced. According to the website’s reporting, the investigation started when another cardiothoracic surgeon within the Asante Health System stepped forward and reported that Carmeci had been committing fraud. According to that colleague, he was continuously harassed by management after reporting Carmeci’s behavior. The U.S. government then got involved.
Click here to read more of The Lund Report’s coverage.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.