AnMed Health to pay $7 million to settle False Claims Act allegations

WSPA Channel 7 News Columbia SC- Published: September 27, 2017, 10:58 am Updated: September 27, 2017, 12:37 pm COLUMBIA, SC (WSPA) – AnMed Health has agreed to pay over $7 million to settle allegations that it submitted false Medicare claims. A news release from the U.S. Attorney’s Office states “AnMed Heath knowingly disregarded the statutory conditions for submitting claims to the Medicare program for a variety of services, including radiation oncology services, emergency department services, and clinic services.” Prosecutors allege “AnMed Health billed for radiation oncology services for Medicare patients when a qualified practitioner was not immediately available to provide assistance and direction throughout the radiation procedure, as required by Medicare regulations.” AnMed is also accused of billing a minor care clinic as if it was an emergency department and billed emergency department services as if they were provided by a physician, but were rendered by mid-level providers, according to the news release. Prosecutors say those practices resulted in higher reimbursements to AnMed Health. The allegations came to light following a lawsuit filed by Linda Jainniney. Prosecutors say Jainniney is a whistleblower who used to work for AnMed Health. “This is another example of how the False Claims Act whistleblower provisions help protect the public’s interest,” U.S. Attorney John Horn said in a statement. “It also reflects our ongoing commitment to safeguard our federal health care programs and the vital care that they provide.” “Protecting people with Medicare and guarding health resources are top priorities,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Provider organizations seeking to increase profits at the expense of patients and taxpayers should expect such plans to [...]