St. Peter's Health, based in Helena, Mont., agreed to pay $10,844,201 to resolve allegations it violated the False Claims Act by submitting false claims to federal healthcare programs on behalf of a physician formerly employed by the system.
Between Jan. 1, 2015 and Dec. 31, 2020, St. Peter's allegedly submitted false claims to federal healthcare programs such as Medicare and Medicaid on behalf of Thomas Weiner, MD, a former oncologist with the health system, according to an Aug. 27 news release from the Justice Department. Dr. Weiner submitted claims that were coded at a higher level of service than was actually performed or did not meet the requirements for separate services administered on the same day, which the government contends the health system knew, or should have known, that the claims were false. St. Peter's also improperly compensated Dr. Weiner based on this incorrect documentation.
St. Peter's voluntarily self-disclosed the misconduct and assisted in investigations beyond what was legally required, which was noted by the Justice Department. The health system also strengthened its corporate compliance program.
"Our health care providers simply must submit accurate claims when billing these taxpayer-supported federal health care programs for services," U.S. District Attorney Jesse Laslovich said in the release. "This settlement would not have been possible without the cooperation of St. Peter's Health, who voluntarily disclosed the misconduct and cooperated with federal investigators to identify the problem and amount of false billing."
The system was ordered to pay the settlement amount within 30 days.