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Bon Secours Mercy Health to pay more than $1 million to settle false claims allegations

by John R. Fischer, Senior Reporter | January 24, 2022
Business Affairs Insurance
Bon Secours Mercy Health will pay more than $1 million to settle False Claims allegations
Bon Secours Mercy Health will pay over $1 million to settle accusations that it falsely diagnosed patients with sleep apnea and submitted claims to Medicare related to treatment.

Bon Secours Mercy Health System was formed in 2018 through a merger between Mercy Health and Bon Secours Health System. Prior to this, Bon Secours Health System allegedly billed Medicare between 2013 and 2017 for tests and equipment used to care for patients that were falsely diagnosed with sleep apnea, said officials with the U.S. attorney’s office.

Brought under the False Claims Act, the case against it alleged that the healthcare system inaccurately reported test results and produced reports on sleep tests that were diagnosed by noncertified sleep technicians, according to The Enquirer.

"Many of Mercy's tests were inaccurately scored, did not qualify for Medicare reimbursement and resulted in medically unnecessary claims for CPAP and BiBAP machines,” said U.S. District Attorney Kenneth Parker of the Southern District of Ohio in a statement on Friday while announcing the settlement.

The settlement was unsealed this week in federal court and says that Bon Secours Mercy Health has agreed to pay $1,029,434.

A spokesperson for Bon Secours Mercy Health told The Enquirer that the company does not comment on litigation.

Bon Secours Mercy Health runs 50 hospitals in seven states and Ireland. It set up most of its executive operations in 2019 in Cincinnati’s Bond Hill neighborhood, calling it a “hub” rather than headquarters, reported The Enquirer at the time. While one system now, both Bon Secours and Mercy Health retain their pre-merger names and branding.

Mercy Health recently opened up a women’s radiology center at its Urbana Hospital, which features new DEXA machines, mammography systems and upgraded ultrasound units, as well as upgraded CT, nuclear medicine and X-ray suites.

And like other U.S. hospitals, the health system is currently focused on caring for COVID-19 patients. Just this week, Mercy Health announced that Mercy Health – Springfield Medical Center has brought in 20 Ohio National Guard members to support healthcare teams and providers throughout the pandemic, reported NBC 2 News.

The 20 guards are one of several groups that have been deployed to hospitals in the same area, as Clark County experiences its highest-ever COVID-19 case rates. “Cases are exploding here. We are looking at over 3000 cases over the last week and over 22-hundred cases per 100 thousand,” said Clark County Combined Health District Health Commissioner Charles Patterson.

Mercy Health also announced this month that it would continue nonemergency elective surgeries on a limited basis, despite other healthcare systems postponing procedures in light of the high number of COVID-19 hospitalizations in Clark and Champaign counties, according to the Dayton Daily News.

It has a task force that is monitoring the pandemic and its impact on care, and it will be making decisions as needed to prioritize the health and safety of both hospital associates and patients.

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