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Santa Fe hospital agrees to pay US for wrong billings

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Christus St. Vincent Hospital in Santa Fe has agreed to pay the U.S. government more than $563,000 for bills allegedly charged wrongly to government healthcare payers over seven years.

In early 2020, the hospital self-disclosed to the U.S. Attorney’s Office concerns about the billing practices of Dr. Arthur Caire, an employee of the hospital.

“Health care providers play an essential role in rooting out and preventing fraud,” said acting U.S. Attorney Fred Federici.“We acknowledge and appreciate the hospital’s decision to come forward and cooperate with our investigation.”

Following an investigation by the U.S. Attorney’s Office, and with the cooperation of the hospital, the government concluded that the hospital billed government agencies for services Dr. Caire did not provide or properly supervise, according to a Wednesday announcement by the U.S. Justice Department.

The hospital agreed to pay the United States $563,810 to resolve the government’s allegations. The settlement covers Dr. Caire’s entire period of employment at the hospital, which spanned from October 2013 until April 2020. Reimbursements will be made to multiple federal healthcare programs, including Medicare, Medicaid, TRICARE and the Federal Employees Health Benefit Program.

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The U.S. government expends more than $1 trillion dollars annually to provide health care to the beneficiaries of federal healthcare programs, the U.S. Justice Department stated. In fiscal year 2019 alone, the federal government recovered more than $3.6 billion dollars attributable to healthcare fraud judgments and settlements.

Assistant U.S. Attorney Sean Cunniff and Auditor Julie Chappell represented the United States in this matter.