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RICHMOND, Va. –Bon Secours Health System, Inc., located in Marriottsville, Maryland, and one of its surgical oncologists, Dr. Eugene Y. Chang, M.D., of Suffolk, have agreed to pay $400,000 to settle civil fraud allegations that while at Bon Secours Maryview Medical Center in Portsmouth, Dr. Chang billed Medicare and other federal healthcare payors for non-covered breast examinations and ultrasounds.
The settlement resolves allegations that from June 1, 2010, through Dec. 31, 2014, Dr. Chang falsified documents with diagnosis codes, such as "lump or mass in breast," where none existed. Chang allegedly did this in order to induce federal healthcare payors such as Medicare to pay for non-covered “screening” breast examinations in connection with routine screening mammograms as if they had been reimbursable “diagnostic” breast examinations. Chang would assign a code that requires a chief complaint from the patient, indicating to Medicare and other payors that the examination was “diagnostic,” while patient charts maintained by Dr. Chang indicated that the patient had no complaint. Additional allegations resolved by the settlement include arranging for certain patients to receive screening breast examinations and screening breast ultrasounds at approximately six-month intervals following screening mammograms, and improperly billing these services as “diagnostic,” which resulted in federal healthcare programs paying for non-covered screening examinations and ultrasounds.
The settlement resolves allegations in a lawsuit filed in the U.S. District Court for the Eastern District of Virginia by a former Bon Secours practice manager and a former colleague of Dr. Chang under the qui tam, or whistleblower provisions of the False Claims Act. Under the False Claims Act, private citizens, also known as relators, can bring suit on behalf of the United States and share in any recovery. The relator share in this settlement is $108,000.
The relators alleged that Bon Secours’ management had specific knowledge of Dr. Chang’s activities after the relators alerted Bon Secours to the problem in August 2011.
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney's Office for the Eastern District of Virginia, the Department of Health and Human Services, the Office of Inspector General, the Defense Criminal Investigative Service, and the U.S. Office of Personnel Management, Office of the Inspector General.
The matter was investigated by Assistant U.S. Attorney Robert McIntosh. The civil claims settled by this False Claims Act agreement are allegations only; there has been no determination of civil liability.
A copy of this press release may be found on the website of the U.S. Attorney’s Office for the Eastern District of Virginia.