United States Settles Health Care Fraud Action Involving Allegations that Hospital Billed for Medically Unnecessary Lab Tests
Crittenton Hospital Medical Center and the Crittenton Cancer Center, together with their current owners Ascension Michigan and Ascension Health, have agreed to pay $791,047 to resolve allegations that they violated the False Claims Act by billing for medically unnecessary laboratory testing for patients who had been referred to Crittenton by Dr. Farid Fata and physicians in his office. In an earlier unrelated criminal matter, Fata pleaded guilty to health care fraud, conspiracy to pay and receive kickbacks, and promotional money laundering, and was sentenced to a term of 45 years in prison.
False Claims Act allegations against Fata and Crittenton were brought to the government by a whistleblower, known as a relator, under the qui tam provisions of the False Claims Act. From September 2011 until August 7, 2013, Fata’s medical practice, Michigan Hematology-Oncology P.C., employed relator as an office administrator. Among other allegations, relator questioned the medical necessity of services that Crittenton and other hospital subsidiaries of Ascension Health had provided to patients treated by Fata.
Crittenton and Ascension voluntarily disclosed to the government the lack of medical necessity regarding the laboratory testing. Relator will receive $158,209.40 out of the $791,047 settlement for his role in filing the qui tam action.
This case was investigated jointly by the U.S. Attorney’s Office for the Eastern District of Michigan and the Department of Health and Human Services, Office of Inspector General.