CHRISTUS HEALTH AFFILIATES IN TEXAS PAYS U.S. $1.36 MILLION
TO SETTLE ALLEGATIONS OF MEDICARE AND MEDICAID FRAUD

WASHINGTON, D.C. - Three San Antonio, Texas affiliates of Christus Health of Houston have paid the United States $1.36 million to settle claims that the Christus affiliates defrauded Medicare and Medicaid from 1997 through 2000, the Justice Department announced today. The civil settlement resolves allegations that Primary CareNet of Texas (PCN) (also known as Christus Primary CareNet) and Health Texas Medical Group (HTMG), on its own behalf and as successor in interest to Solomon Anthony Clinic (SAC), defrauded the programs by improperly charging Medicare and Medicaid for physicians' evaluation and management services.

"This settlement again demonstrates the United States' commitment to protecting federal funds from fraud and abuse," said Robert D. McCallum, Assistant Attorney General in charge of the Civil Division. "The federal health care system operates on the good faith and honesty of its providers, and we will actively pursue those who misuse the system for financial gain."

The allegations arose from a lawsuit filed by PCN’s former Chief Financial Officer, Timothy Ohman, under the qui tam or whistleblower provisions of the False Claims Act, a federal law that allows private individuals to sue on behalf of the United States. Ohman alleged that PCN, a management and billing company, and HTMG and SAC, two physician practice groups, improperly charged evaluation and management services for Medicare and Medicaid patients. As a result, HTMG and SAC received more reimbursement from Medicare and Medicaid than they should have.

"Medicare and Medicaid fraud and abuse is a crime against the American taxpayer," stated Johnny Sutton, United States Attorney, Western District of Texas. “With vigorous enforcement actions such as these, we help to insure the future of the Medicare and Medicaid Trust Funds”

The civil investigation and settlement were jointly handled by the Office of the United States Attorney for the Western District of Texas and the Civil Division of the Department of Justice, with assistance of the Department of Health and Human Services Office of Inspector General, including the Office of Counsel and the Federal Bureau of Investigation.

The case is entitled U.S. ex rel. Ohman v. Primary CareNet, et al., No. SA-01-CA-150-IV (W.D.Tex.).

###

03-274