AGREEMENT PRESS RELEASE
Sanford Health Entities to Pay $20.25 Million to Settle False Claims Act Allegations Regarding Kickbacks and Unnecessary Spinal Surgeries
Published by the United States Department of Justice | View article on www.justice.gov
The Department of Justice announced today that hospital entities Sanford Health, Sanford Medical Center, and Sanford Clinic (collectively, Sanford), of Sioux Falls, South Dakota, have agreed to pay $20.25 million to resolve False Claims Act allegations that they knowingly submitted false claims to federal healthcare programs resulting from violations of the Anti-Kickback Statute and medically unnecessary spinal surgeries. The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally-funded programs.
ENFORCEMENT ACTIONS
Sanford Health, Sanford Clinic, and Sanford Medical Center Agreed to Pay $25,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Telemedicine Services that Did Not Meet Applicable Requirements
Penalty Amount: $0
Filed under: CIA Reportable Events, COVID-19
After they disclosed conduct to OIG pursuant to their CIA, Sanford Health, Sanford Clinic, and Sanford Medical Center (collectively, “Sanford”), South Dakota, entered into a $25,842 settlement agreement with OIG. OIG alleged that Sanford submitted claims to Medicare, Medicaid, TRICARE, and the Health Resources and Services Administration’s COVID-19 Uninsured Program for telemedicine services provided by a physician that did not meet applicable requirements. Specifically, OIG alleged that Sanford submitted claims for services that: (1) were scheduled for times when the physician was out of the country and without access to Sanford’s approved telemedicine platform; (2) did not involve interactive two-way video and audio as required; and (3) purported to be for multiple family members when the physician had only spoken to one family member.