ST. MARY'S OF MICHIGAN PAYS $3.49 MILLION IN VOLUNTARY
DISCLOSURE OF IMPROPER BILLING FOR CHEMOTHERAPY
Claim Relates to Supervision of Chemotherapy Infusions in Bad Axe, Michigan
DETROIT – St. Mary's of Michigan, a non-profit entity that owns and operates the Seton Cancer Institute and other health care facilities in Michigan, has agreed to pay the United States $3.49 million as a result of its voluntary disclosure that its billing for chemotherapy infusions performed in Bad Axe, Michigan did not comply with Medicare and Medicaid requirements over a period of seven years, the U.S. Attorney's Office in Detroit announced today.
Medicare and Medicaid rules prohibit any billing for chemotherapy performed in an outpatient clinic setting unless there is a physician available within the clinic when chemotherapy is administered. Until April 1, 2011, St. Mary's operated an oncology clinic within leased space in the Huron Medical Center in Bad Axe, Michigan and administered chemotherapy there three or four days a week without a physician present in the clinic. St. Mary's discovered the problem through a self-audit and brought it to the attention of federal authorities.
U.S. Attorney Barbara McQuade praised St. Mary's and John R. Graham, St. Mary's President and Chief Executive Officer, for instituting a self-audit procedure, for ceasing the conduct on its own initiative and for coming forward to disclose it.
"We applaud the legitimate providers who are responsible participants in the Medicare program," said McQuade. "Too many health care providers do not take appropriate steps to ensure that their claims to Medicare are legitimate. We encourage other providers in our area to follow St. Mary's example."
The case was handled by the U.S. Attorney's Office for the Eastern District of Michigan, the Michigan State Office of the Attorney General, the Office of Inspector General of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services.