Johnson's office recently settled an alleged fraud case involving two doctors at Dakotas-based Sanford Health. Court documents show that Sanford paid $625,000 to settle the lawsuit, in which the doctors and the hospital did not admit wrongdoing. Cindy Morrison, Sanford's executive vice president for marketing and public policy, said the hospital settled to avoid distraction.
"For us, it's the issue of time and expense," she said.
In the Sanford case, a whistleblower accused the doctors of defrauding federal health care programs. A person who has knowledge of fraud can sue on behalf of the federal government to recover money under the Federal False Claims Act, said Monica Navarro, a professor at Thomas M. Cooley Law School in Michigan and an expert in so-called "qui tam" lawsuits.
The government in the Sanford case alleged almost $375,000 in damages to Medicare, Medicaid and Veterans Affairs from May 2010 to April 2011, Johnson said. The damages were multiplied by 1.66, and Medicare received most of the damages, more than $432,000.
U.S. Attorney Timothy Purdon of North Dakota said his office has added a special prosecutor — in concert with HHS — who works specifically on cases involving doctors and others who work with Fargo-based Noridian Healthcare Solutions. Noridian handles Medicare claims for many states.
Purdon's office recently prosecuted a case involving a Seattle doctor accused of turning in phony Medicare claims that included reports of nursing home visits to patients who were dead.
U.S. District Judge Ralph Erickson earlier this month sentenced John C. Chen to one year of probation and ordered him to pay restitution of more than $56,600 to the Centers for Medicare and Medicaid Services, which he satisfied as part of $150,000 civil settlement in Washington state.
"This has been a successful program for us in the last couple of years," Purdon told The Associated Press. "It has given us resources as a small district that we wouldn't have to battle this issue."
