John Muir Health Agrees To $550K To Settle Medicare Dispute

John Muir Health has agreed to pay $550,000 after a whistleblower claimed the health care company was not using physicians to supervise radiation therapy treatment.

Representatives from John Muir Health said in a statement that they simply failed to adequately document the presence of physicians during the treatment.

According to the U.S. Attorney’s Office, the whistleblower claimed that between Jan. 2009 and Dec. 2013, physicians, who were contracted with John Muir Health to deliver radiation therapy, failed to supervise that treatment, which is a condition of receiving payment through Medicare. In its statement, representatives from John Muir Health said the company did not admit to any wrongdoing.

“John Muir Health worked diligently to secure compliance with the physician presence requirement as defined by Medicare, even though the standard changed frequently during the time under review, but did not always adequately document the presence of physicians,” the statement reads. “Nonetheless, as medical centers that operate around the clock, physicians are always present at our facilities at all times.”

The company has now taken measures to better document physicians’ presence during the treatment, company representatives said.

The former employee used a provision in the law that allows private citizens to file a lawsuit on behalf of the government and to receive a portion of the judgment.

She will receive $110,000 as part of the settlement, according to officials in the U.S. Attorney’s Office, and John Muir Health will have to pay $65,000 in her attorneys’ fees, company representatives said.

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