PHOENIX – Neurosurgical Associates and Dignity Health’s St. Joseph’s Hospital have agreed to pay $10 million to resolve civil allegations that they violated the federal False Claims Act (FCA).
Dignity Health is one of the largest healthcare systems in the United States and does business under the names of hospitals that it owns and operates, including St. Joseph’s Hospital in Phoenix, Arizona. Neurosurgical Associates, LTD is an Arizona corporation, located on the campus of St. Joseph’s Hospital.
The December 2020 settlement resolves allegations that St. Joseph’s Hospital and Neurosurgical Associates, LTD billed Medicare for certain doubly and triply concurrent and overlapping surgeries, in violation of applicable regulations and reimbursement policies.
The settlement is part of a lawsuit filed in June 2018 by Dr. Bruce P. Kingsley under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and share in any recovery obtained.
Contemporaneous with a settlement of the FCA claims in this matter, Neurosurgical Associates, LTD entered into a corporate integrity agreement (CIA) with the Department of Health and Human Services Office of Inspector General (HHS-OIG). The five-year CIA addresses the conduct at issue and requires, among other things, that Neurological Associates, LTD maintain a compliance program, implement a risk assessment program, and hire an Independent Review Organization to annually review Neurosurgical Associates’ Medicare and Medicaid claims.