John Muir Health Agrees To Pay $550,000 To Resolve False Claims Allegations
Medical Provider Resolves Claims Regarding Alleged Failure to Supervise Oncological Treatment
SAN FRANCISCO – John Muir Health has agreed to pay the government $550,000 to resolve allegations that it submitted false claims for Medicare reimbursement, announced United States Attorney Melinda Haag, Department of Health and Human Services Office of Inspector General (OIG) Special Agent in Charge Ivan Negroni, and Federal Bureau of Investigation Special Agent in Charge David J. Johnson.
The settlement, unsealed by U.S. District Judge Samuel Conti, resolves a whistleblower lawsuit filed in the United States District Court for the Northern District of California. The United States’ investigation revealed that between January 1, 2009, and December 31, 2013, physicians who were contracted with John Muir Health to deliver radiation therapy failed to adequately supervise that treatment. The proper supervision of radiation therapy is a condition of payment for Medicare.
A former employee of John Muir Health filed the case pursuant to the qui tam provisions of the False Claims Act, 31 U.S.C. §§ 3729-33. Under those provisions, private citizens, known as “relators,” may file lawsuits on behalf of the United States and receive a portion of a settlement or judgment. In this case, the relator will receive $110,000 as her share of the government’s recovery.
Assistant U.S. Attorney Melanie L. Proctor handled the matter on behalf of the U.S. Attorney’s Office for the Northern District of California, with assistance of Paralegal Tiffani Chiu. The settlement with John Muir Health is the result of an investigation by the OIG and the Federal Bureau of Investigation.