Calif. Health Giant Sutter To Pay $60M To End FCA Claims

By Hailey Konnath (August 31, 2021, 7:12 PM EDT) -- Sutter Health has agreed to pay $60 million to put to rest a False Claims Act suit alleging that the California-based health services provider billed for unsupported diagnoses of Medicare Advantage beneficiaries, according to a settlement announced Monday.

The government had claimed that Sutter Health knowingly submitted unsupported diagnosis codes for certain patient encounters for beneficiaries under its care. Those codes caused Sutter Health to get inflated payments, the U.S. Department of Justice alleged. And even once Sutter Health realized what was happening, it failed to take care of the problem, according to the Justice Department.

Sutter Health noted in a...

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