Healthcare provider to pay $1M for Medicare claims related to false sleep apnea diagnoses

CINCINNATI (WXIX) - A healthcare provider based in Ohio has agreed to pay $1 million as part of a False Claims Act settlement that was unsealed this week, according to US Attorney Kenneth Parker.

Bon Secours Mercy Health, Inc., based in Cincinnati, operates hospitals, sleep centers, and other health care facilities in multiple states and in Ireland.

According to the settlement, from 2013 through 2017, Mercy submitted Medicare claims for payment by falsely diagnosing patients with sleep apnea. Mercy billed for tests and equipment related to the treatment of sleep apnea.

Parker said the complaint detailed allegations that Mercy inaccurately reported test results and created reports from sleep tests with the resulting diagnoses made by non-certified sleep technologists.

The US attorney said many of Mercy’s tests were inaccurately scored, did not qualify for Medicare reimbursement, and resulted in medically unnecessary claims for CPAP and BiPAP machines.

Mercy has agreed to pay $1,029,434, according to Parker.

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