United States ex rel. Carroll v. Adventist Health Systems, et al., Case No. CV-10-4925 DMR
A settlement in the amount of $2,250,000, payable by St. Helena Hospital, to the United States, stems from allegations that it submitted false claims to Medicare for certain cardiac procedures and related inpatient submissions.
Former employee of St. Helena Hospital, Kacie Carroll, filed the qui tam action in the U.S. District Court for the Northern District of California. Carroll will receive $450,000.
During the period from 1/1/2008 through 7/31/2011, it was alleged, that St. Helena Hospital knowingly charged Medicare for medically unnecessary percutaneous coronary interventions, more commonly known as angioplasty, the surgery performed to open narrowed or blocked blood vessels that supply blood to the heart. In addition, it was also alleged that the hospital unnecessarily admitted angioplasty patients who should have been treated on a less costly, outpatient basis.