Bon Secours Health, oncologist to pay $400,000 over false claims allegations
While at Bon Secours Maryview Medical Center in Portsmouth, oncologist billed Medicare, other payers for non-covered services, authorities say.
Bon Secours Health System and Eugene Y. Chang, MD, one of the system's surgical oncologists, will pay $400,000 to settle civil fraud allegations leveled against them in a whistleblower lawsuit filed by a former Bon Secours practice manager and former colleague of Chang, the Department of Justice announced Monday. The suit alleges that while at Bon Secours Maryview Medical Center in Portsmouth, Virginia, Chang billed Medicare and other federal healthcare payers for breast exams and ultrasounds that were not actually covered.
Bon Secours Health System is located in Marriottsville, Maryland. According to the DOJ, the settlement resolves allegations that for more than four years from June 1, 2010 through December 31, 2014, Chang falsified documents containing codes like "lump or mass in breast", where none actually 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," the DOJ said in a statement. "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 Chang indicated that the patient had no complaint."
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The settlement resolved additional allegations that indicated Chang arranged for certain patients to receive breast exams and ultrasounds every six months following screening mammograms, then billed these services as "diagnostic". This practice resulted in federal healthcare programs paying for services that were not covered, the DOJ said.
The whistleblowers in this case alleged that Bon Secours' management knew about Chang's alleged activities, having alerted them to the issue in August of 2011, a little more than a year after the activities began. Under the False Claims Act, private citizens who file whistleblower, or qui tam, lawsuits receive a portion of the recovery. In this case, that amount was $108,000.
Twitter: @BethJSanborn
