Calif.-Based Sutter Health Agrees To $30M Settlement Over Allegations Of Submitting Inflated Diagnosis Codes To CMS

By April 15, 2019 News No Comments

The Department of Justice alleged that Sutter and its affiliates had submitted diagnosis codes that inflated the risk scores for certain beneficiaries in their care. “With some one-third of people in Medicare now enrolled in managed care…plans, large health care systems such as Sutter can expect a thorough investigation of claimed enrollees’ health status,” said Steven J. Ryan, special agent in charge with the Office of Inspector General for the U.S. Department of Health and Human Services.