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CIA Reportable Event Settlements

Providers under a Corporate Integrity Agreements (CIA) or Integrity Agreements (IA) with the OIG are required to disclose certain "Reportable Events" which include: a substantial overpayment, a matter that a reasonable person would consider a probable violation of criminal, civil, or administrative laws applicable to any Federal health care program for which penalties or exclusion may be authorized; and the employment of or contracting with an excluded individual. Matters disclosed to the OIG as a Reportable Event may implicate OIG's Civil Monetary Penalty authorities.

04-02-2020
After it disclosed conduct to OIG pursuant to its CIA, Envision Healthcare Corporation and its subsidiaries and affiliates (Envision), entered into a $50,250 settlement agreement with OIG. OIG alleged that Envision paid remuneration to approximately 500 hospital senior executives nationwide in the form of Google Home Mini devices with Envision's name printed on the devices.
03-18-2020
After it disclosed conduct to OIG pursuant to its CIA, SMHA Healthcare, Inc. f/k/a Memorial Health, Inc. (Memorial), SMHA Healthcare Center, Inc. f/k/a Memorial Health University Medical Center, Inc. (MHUMC), SMHA Health Services Group, Inc. f/k/a Provident Health Services, Inc., and SMHA Ventures, Inc. f/k/a MPPG, Inc. (MPPG) (collectively, "Memorial Health"), enter into a $910,450 settlement agreement with OIG. The settlement agreement resolves allegations that Memorial Health paid improper renumeration to physician entities in the following arrangements: (1) Memorial's hospital-affiliated physician practice group, MPPG, leased space for more than fair market value; (2) Memorial subsidiaries MHUMC and MPPG leased space for more than fair market value, and (3) Memorial subsidiary MHUMC provided free anesthetic agent and free IT services to an ambulatory surgery center that is a joint venture between MHUMC and another physician practice.
10-23-2019
After it disclosed conduct to OIG pursuant to its CIA, Medi-Lynx Cardiac Monitoring, LLC (Medi-Lynx), entered into a $71,595.27 settlement agreement with OIG. OIG alleged that Medi-Lynx employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-01-2019
After it disclosed conduct to OIG pursuant to its CIA, Drayer Physical Therapy, LLC (Drayer), entered into a $81,455.97 settlement agreement with OIG. OIG alleged that Drayer billed and received reimbursement from Tricare for physical therapy services that were provided by physical therapy assistants.
09-09-2019
After it disclosed conduct to OIG pursuant to its CIA, Mercy Hospital Springfield, Mercy Clinic Springfield Communities, and MHM Support Services (collectively, "Mercy"), Missouri, entered into a $178,863.78 settlement agreement with OIG. OIG alleged that Mercy improperly submitted claims for Modified Barium Swallow Tests that did not meet the applicable physician supervision requirements.
09-26-2018
On September 26, 2018, The Ensign Group (Ensign), Avenues Healthcare, Inc. d/b/a City Creek Post-Acute (City Creek), and Cardiff Healthcare, Inc. d/b/a Paramount Health and Rehabilitation (Paramount), entered into an $18,525.89 settlement with OIG. Ensign made a disclosure submission concerning its subsidiaries City Creek and Paramount pursuant to its CIA. The settlement agreement resolves allegations that Ensign, through City Creek and Paramount, employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
On September 26, 2018, The Ensign Group (Ensign) and Wellington Healthcare, Inc. d/b/a Wellington Place Living and Rehabilitation Center (Wellington), entered into a $9,276 settlement with OIG. Ensign made a disclosure submission concerning its subsidiary Wellington pursuant to its CIA. The settlement agreements resolves allegations that Ensign, through Wellington, employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
On September 26, 2018, The Ensign Group (Ensign), Livingston Care Associates d/b/a Timberwood Nursing and Rehabilitation Center (Timberwood), and 24th Street Healthcare Associates, LLC d/b/a Desert Terrace Healthcare Center (Desert Terrace), entered into a $7,583.47 settlement agreement with OIG. Ensign made a disclosure submission concerning its subsidiaries Timberwood and Desert Terrace pursuant to its CIA. The settlement agreement resolves allegations that Ensign, through Timberwood and Desert Terrace, employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.
09-19-2018
On September 19, 2018, The Ensign Croup (Ensign), Avenues Healthcare, Inc. d/b/a City Creek Post-Acute (City Creek), and Wellington Healthcare, Inc. d/b/a Wellington Place Living & Rehabilitation Center (Wellington), entered into an $80,716.61 settlement agreement with OIG. Ensign made a disclosure submission concerning its subsidiaries City Creek and Wellington pursuant to its CIA. The settlement agreement resolves allegations that Ensign, through City Creek and Wellington, employed two individuals that it knew or should have known were excluded from participation in Federal health care programs.
11-06-2017
On November 6, 2017, P.T.C.H., Inc. d/b/a Palm Terrace Care Center (PTCC), a skilled nursing facility contractually affiliated with North American Health Care, Inc. (NAHC, Inc.), entered into a settlement agreement with OIG. After NAHC, Inc. disclosed conduct to OIG pursuant to its CIA, PTCC agreed to pay $765,637.68 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that PTCC, Riverside, California, employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
On November 6, 2017, Northwest Care-Shoreline, Inc. d/b/a Park Ridge Care Center (PRCC), a skilled nursing facility contractually affiliated with North American Health Care, Inc. (NAHC, Inc.), entered into a settlement agreement with OIG. After NAHC, Inc. disclosed conduct to OIG pursuant to its CIA, PRCC agreed to pay $45,353.72 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that PRCC, Shoreline, Washington, contracted with an individual that it knew or should have known was excluded from participation in Federal health care programs.
On November 6, 2017, C.P.C.H., Inc. d/b/a Chatsworth Park Health Care Center (CPHCC), a skilled nursing facility contractually affiliated with North American Health Care, Inc. (NAHC, Inc.) entered into a settlement agreement with OIG. After NAHC, Inc. disclosed conduct to OIG pursuant to its CIA, CPHCC agreed to pay $32,114.64 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that CPHCC, Chatsworth, California, employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
10-11-2017
After it disclosed conduct to OIG pursuant to its CIA, Memorial Health, Inc. (Memorial), Savannah, Georgia, agreed to pay $264,848.36 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Memorial employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
07-21-2017
On July 21, 2017, Luitpold Pharmaceuticals, Inc. (LPI) and American Regent, Inc. (ARI), entered into a $1,237,100 settlement agreement with OIG. Daiichi Sankyo, Inc. made a disclosure submission concerning its subsidiaries LPI and ARI pursuant to its CIA. (LPI and ARI are "Daiichi Affiliates" covered by certain CIA requirements.) The settlement agreement resolves allegations that LPI and ARI provided remuneration to a physician and her practice in the form of payments made and services provided in connection with an iron deficiency anemia management pilot program.
01-12-2017
After it disclosed conduct to OIG pursuant to its CIA, Pediatric Services of America, Inc. (PSA), agreed to pay $197,556.66 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that PSA, at one of its locations in Pennsylvania, employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
12-22-2016
After it disclosed conduct to OIG pursuant to its CIA,CVS Health Corporation, Caremark Rx, LLC, and nine of its pharmacy benefit management subsidiaries (collectively, "CVS"), headquartered in Rhode Island, agreed to pay $2,000,000 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that CVS, acting as the Pharmacy Benefit Manager for its clients, improperly rejected, denied, or reduced pharmacy payments on claims by state Medicaid, Veterans Affairs, Indian Health Services, and Military Health System programs for beneficiaries of these programs where the beneficiaries were also eligible for benefits under CVS's administered programs.
10-26-2016
After it disclosed conduct to OIG pursuant to its CIA, WakeMed Health & Hospitals (WakeMed), North Carolina, agreed to pay $146,235.38 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that WakeMed paid remuneration to one non-employed medical director in the form of medical director fees.
08-31-2016
After it disclosed conduct to OIG pursuant to its CIA, DaVita Healthcare Partners (DaVita), headquartered in Colorado, agreed to pay $5,008,732.14 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that DaVita paid remuneration to five physician practices in the form of Medical Director fees that DaVita knew were in excess of fair market value.
After it disclosed conduct to OIG pursuant to its CIA, DaVita Healthcare Partners (DaVita), headquartered in Colorado, agreed to pay $175,049 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that DaVita paid remuneration to two hospitals in the form of admitting patients who had been discharged from the hospitals without a payor source, and absorbing the costs of the patients' treatment. DaVita failed to enter into agreements with the hospitals to ensure that payments for services were received prior to DaVita's admission of and provision of care to these patients.
05-06-2016
After it disclosed conduct to OIG pursuant to its CIA, Amedisys, Inc. (Amedisys), headquartered in Louisiana, agreed to pay $4,677,642 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Amedisys filed claims to Medicare for home health services that were not medically necessary and did not meet the requirements for payment under Medicare.
03-23-2015
After it disclosed conduct to OIG pursuant to its CIA, LifeWatch Services, Inc. (LifeWatch), Illinois, agreed to pay $737,572.50 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that LifeWatch submitted claims to Medicare for Ambulatory Cardiac Telemetry (ACT) services for which the medical record documentation did not support that the physician had ordered ACT services.
02-04-2015
After it disclosed conduct to OIG pursuant to its CIA, W.A. Foote Memorial Hospital d/b/a Allegiance Health (Allegiance), Michigan, agreed to pay $2,635,441.35 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Allegiance submitted claims to Federal health care programs for hyperbaric oxygen therapy services that did not meet Provider-Based Regulations.
12-18-2014
After it disclosed conduct to OIG pursuant to its CIA, WakeMed Raleigh Campus (WakeMed), North Carolina, agreed to pay $364,062.51 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that WakeMed paid remuneration to a cardiology practice and physician to render medical director services and cardiac electrophysiology services to WakeMed patients. OIG alleged that WakeMed paid below-fair market value for these services.
07-14-2014
After it disclosed conduct to OIG pursuant to its CIA, Omnicare, Inc. (Omnicare), headquartered in Ohio, agreed to pay $138,513.00 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Omnicare employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
05-01-2014
After it disclosed conduct to the OIG pursuant to its CIA, Quest Diagnostics, Incorporated (Quest), New Jersey, agreed to pay $152,560.51 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Quest employed four individuals that it knew or should have known were excluded from participation in Federal health care programs.
01-27-2014
After it disclosed conduct to OIG pursuant to its IA, Decatur Vein Clinic, LLC, Decatur Vein Clinic, PC, and Decatur Vein Clinic Hobart, PC (Decatur), Indiana, agreed to pay $140,000.00 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Decatur billed and received reimbursement for catheter-infusion sclerotherapy procedures as well as other procedures for the care and treatment for varicose veins of the lower extremities that were not provided as claimed and were false or fraudulent.
07-01-2013
After it disclosed conduct to the OIG pursuant to its CIA, Amerigroup Corporation (Amerigroup), Virginia, agreed to pay $30,754.93 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Amerigroup contracted with three individuals that it knew or should have known were excluded from participation in Federal health care programs and paid for prescriptions written by a fourth individual that it knew or should have known were excluded from participation in Federal health care programs.
03-11-2013
After it disclosed conduct to the OIG pursuant to its CIA, Vanguard HealthCare, LLC (Vanguard), Tennessee, agreed to pay $159,778.00 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Vanguard employed an individual that it knew or should have known was excluded from participation in Federal health care programs.

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