Asante Health System Settles $430,000 Medicare Fraud Allegations

Settlement of Alleged Medicare Fraud

Asante Health System and a cardiothoracic surgeon, Dr. Charles Carmeci, have agreed to pay a sum of $430,000 to settle allegations of Medicare fraud. According to the allegations, both parties knowingly submitted false claims to Medicare, Medicaid, and Tricare for cardiothoracic surgeries that did not qualify for reimbursement or were otherwise improper. These surgeries were performed between 2015 and early 2021.

Despite the settlement, it is important to note that the payment does not constitute an admission of liability. Asante Health System and Dr. Carmeci have both denied the government's allegations. However, the settlement serves to resolve the alleged fraudulent billing probe that was connected to a whistleblower lawsuit.

Whistleblower Lawsuit and FBI Investigation

The lawsuit came to light due to the bravery of one of the hospital’s own doctors, who filed a whistleblower lawsuit. The lawsuit accused the management at Medford hospital of ignoring the billing fraud and targeting the doctor who reported it. This led to a full-scale investigation by the FBI into the allegations raised in the lawsuit. Further, the federal government joined the suit to recoup funds after the investigation.

Dr. Charles Carmeci, the surgeon at the heart of the allegations, was accused of overbilling and performing unnecessary procedures to increase his compensation. No criminal charges have resulted from these claims following the federal investigation.

Asante Rogue Regional Medical Center and Allegations of Ignored Fraud

The lawsuit was filed by former Asante doctor, Nicolas Engstrom. Dr. Engstrom claimed that Dr. Carmeci billed for procedures he didn’t perform, as well as for unnecessary procedures. The lawsuit accused the management of Asante Rogue Regional Medical Center of ignoring the billing fraud.

Asante and Carmeci reached an undisclosed settlement with the government in October. Despite the allegations and the settlement, Dr. Carmeci continues to work as a physician at Asante. He was even listed as the health system's highest-paid employee, earning $2 million in 2022, as per the health system's tax documents.

Impact on Patients

Aside from monetary consequences, the lawsuit and allegations have also raised concerns about potential impacts on patient care. There are reports of patient deaths possibly tied to a nurse's drug diversion at Asante Rogue Regional Medical Center. This underlines the grave implications that such malpractices can have on patient safety and trust in healthcare systems.

While the settlement brings an end to these allegations, it is a stark reminder of the importance of maintaining transparency, accountability, and ethical practices in healthcare. This case not only highlights the role of whistleblowers in holding healthcare providers accountable but also the necessity for thorough investigation and action on such allegations.