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The United States Attorney's Office

Eastern District of Pennsylvania

July 27, 2000 - United States Attorney Michael R. Stiles, on behalf of the Office of Inspector General of the Department of Health and Human Services (OIG-HHS) announced a settlement of civil and administrative claims with the Mercy Health System of Southeastern Pennsylvania (Mercy) in the amount of One million One Hundred Sixty Two Thousand Three Hundred and Thirty Six Dollars.

This settlement resolves civil claims of the United States under the False Claims Act and other federal statues and common law pursuant to a nationwide initiative to review compliance with the rules governing the Medicare part B payments for physicians at teaching hospitals. (The "PATH" initiative).

Mercy had created and implemented a corporate compliance program that centralized, monitored and audited the billing by its physician-employees. This settlement is based on a voluntary audit and self disclosure by Mercy of potential billing violations for these services rendered by its physician-employees in the supervision of resident physicians. The audit was of all claims submitted for the care of 100 patients in inpatient care in the year 1995. The audit revealed that claims had been submitted by Mercy for services rendered by its physician-employees when the records could not substantiate that the respective physicians rendered the service and/or that the claims had been submitted at coded levels that were not supported by the records. The results of the audit were projected over the period 1993 through 1996 for settlement purposes.

In light of Mercy's voluntary disclosure and self audit, and upon OIG-HHS's evaluation of Mercy's compliance structure, the settlement agreement also provides that Mercy will continue to implement its corporate compliance program without the need for a Corporate Integrity Agreement overseen by OIG-HHS.

This matter was handled by Assistant United States Attorney Margaret L. Hutchinson. The audit was reviewed by the OIG -HHS's Office of Audit Services, Philadelphia Region.

Mercy was represented by Mark T. Bullock, General Counsel and James K. Seaman, Corporate Compliance Officer.


UNITED STATES ATTORNEY'S OFFICE
EASTERN DISTRICT, PENNSYLVANIA
Suite 1250, 615 Chestnut Street
Philadelphia, PA 19106
Contact:
MICHAEL L. LEVY
First Assistant U. S. Attorney
215/861-8599

Updated December 15, 2014

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