Helena Hospital Ordered to Pay $11 Million for False Claims Act

Missoula, MT (KGVO-AM News) - A Helena hospital, St. Peter’s Health, has been ordered to pay nearly $11 million to resolve allegations that it violated the False Claims Act by submitting claims for payments to federal healthcare programs for services performed by an oncology doctor.

I spoke with U.S. Attorney for the State of Montana Jesse Laslovich about the case after a settlement agreement was announced at a press conference in the Helena Federal Courthouse.

A Helena Hospital Will Pay Nearly $11 Million for Violating the False Claims Act

“We had a press conference today announcing a settlement with St. Peter's Health regarding allegations by our office of violations of the False Claims Act committed by St. Peter's in relation to Dr. Tom Weiner, who was an oncologist at St. Peter's up until a few years ago, for submitting false claims to Medicare and Medicaid and some other federal agencies such as TRICARE, and the claims were up-coded or they were nonpayable,” began Laslovich. “In other words, the claims should not have been paid by the federal government.”

Laslovich said the investigation took several years to complete.

The Investigation Took Years to Complete

“We worked over the last few years, and it was an extensive investigation,” he said. “St. Peter's has agreed to pay just under $11 million within 30 days to the United States, Medicare, and Medicaid for the claims that were paid that shouldn't have been paid during the time period.”

Laslovich explained the purpose of the False Claims Act.

“The False Claims Act is in place in large part to protect the American taxpayer from paying for claims that shouldn't be paid,” he said. “We have Medicare and Medicaid, which are federal programs, and we take its enforcement seriously to protect the taxpayer. Ultimately, here, St. Peter's has agreed to pay $11 million to the United States for claims that they submitted and were paid for that shouldn't have been paid for.”

In addition to the hospital, Laslovich said the doctor himself was also culpable.

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A Civil Complaint was Also Filed Against the Helena Oncologist

“Yesterday, we filed a civil complaint in federal district court against Dr. Weiner, who I referenced earlier, for committing health care fraud, for billing for unnecessary treatments, for dispensing opioids in violation of the Controlled Subs Act, and for also submitting claims that shouldn't have been submitted, so that will be litigated with the settlement on the St. Peter's side.”

According to the U.S. Attorney’s Office, ‘The claims resolved by the settlement are allegations only. There has been no determination of liability.’