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DOJ collected $3B+ from healthcare fraud cases in 2019 — 5 cases involving ASCs

The Department of Justice collected over $3 billion from civil cases involving alleged False Claims Act violations in 2019, according to a Jan. 9 announcement.

It was the 10th consecutive year that the DOJ's civil healthcare fraud settlements and judgments surpassed $2 billion. Cases involving drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians accounted for $2.6 billion paid to the federal government.

Five DOJ cases that involved ASCs:

1. The DOJ sued an Orlando, Fla.-based urologist and the outpatient surgery center where he performed procedures over an alleged $3 million kickback scheme.

2. Sacramento, Calif.-based Sutter Health and a three-surgeon cardiovascular group together paid the government over $46 million to settle allegations that they violated Stark Law.

3. Dallas-based Tenet Healthcare planned to pay around $66 million to settle a lawsuit alleging False Claims Act, Anti-Kickback Statute and Stark Law violations for services performed at one of its hospitals.

4. Retina Institute of California Medical Group and seven other defendants — including San Gabriel (Calif.) Ambulatory Surgery Center — paid $6.65 million to settle allegations that they defrauded Medicare and Medicaid, though they did not admit liability.

5. Dallas-based Guardian Pharmacy Services — the manufacturer of a compounded solution at the center of 60 lawsuits — reached a settlement with the federal government. In the dozens of lawsuits filed, patients alleged Guardian's solution caused vision damage within weeks after it was injected during procedures at Medical City Surgery Park Central, formerly Park Central Surgical Center, and Key-Whitman Eye Center, both in the Dallas area. 

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