A settlement has been reached in a whistleblower class action lawsuit brought against Carondelet Health Network who is accused of submitting false bills to Medicare and other federal health care programs.
Carondelet Health Network has agreed to pay $35 million to resolve these claims. The whistleblowerwill receive a share of the settlement of nearly $6 million.
The case was originally filed in November of 2011 and alleges that from April 7, 2004, through Dec. 31, 2011, two of Carondelet's hospitals, St. Mary’s Hospital and St. Joseph’s Hospital, billed Medicare, the Federal Employees Health Benefit Program, and the Arizona Health Care Cost Containment System (Arizona’s Medicaid agency) for inpatient rehabilitation facility services that were not properly reimbursable under applicable coverage criteria because the patients were not appropriate for inpatient rehabilitation facility services. The government alleged that due to these false claims, federal health care programs paid far more than was necessary.