A Southern Oregon healthcare corporation and one of its physicians have agreed to pay $430,000 to settle allegations that they knowingly submitted false claims for payment for cardiothoracic surgeries to Medicare, Medicaid and TRICARE.
The US Attorney's Office for the District of Oregon reports Asante Health System and Dr. Charles Carmeci -- a cardiothoracic surgeon practicing at Rogue Regional Medical Center -- submitted the false claims.
Prosecutors said Asante and Dr. Carmeci submitted claims for payment to the three government insurance companies for various surgeries while knowing they did not meet the criteria for reimbursement or were otherwise improper.
Medicare and Medicaid are public health insurance companies administered by a federal agency within the US Department of Health & Human Services. TRICARE is a civilian health care program administered by the Defense Health Agency, a joint integrated combat support agency within the US Department of Defense.
According to a press release, 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 Health & Human Services Office of Inspector General, FBI and DHA.
