Sacramento – U.S. Attorney Benjamin B. Wagner announced recently that Sutter Health Association has paid $1.4 million and Catholic Healthcare West paid $875,000 to settle allegations that certain of their affiliate hospitals overcharged the government for infusion therapy and lithotripsy services.

Public information officer Lauren Horwood said the “settlements resolve findings by the U.S. Department of Health and Human Services, Office of Audit Services indicating that the two entities overcharged the federal Medicare program.”

Overcharges came through “duplicate charging for the administration of infusion therapy” and “unbundling packaged infusion therapy services when the individual procedures should have been billed as a group.” Overcharges also occurred through duplicate billing under separate revenue codes.

Horwood said: “Lithotripsy is a medical procedure that uses shock waves to break up stones in the kidney, bladder, or ureter.”

Wagner said Catholic Healthcare West, the fifth largest hospital provider in the country and largest hospital system in California, had 36 affiliate hospitals involved in the matter, in California, Nevada, and Arizona.

Sutter Health Association, an integrated health care delivery system, operating in Hawaii and California, had 25 affiliate hospitals involved in the matter, all in Northern California.

Wagner said his “office will actively pursue recovery of Medicare dollars. This settlement not only recoups overpayments made by Medicare, it helps ensure more accurate billing practices by these hospital systems in the future.”

Horwood said “both healthcare providers cooperated fully with the investigations.”

Story by Jim Reece This email address is being protected from spambots. You need JavaScript enabled to view it.