Doctors at the medical center were accused of performing unnecessary procedures to increase Medicare and Medicaid bills.
Updated January 16th at 10:20am: Asante Health System and Dr. Charles Carmesi paid $430,000 to settle Medicare fraud allegations.
According to a news release from the U.S. Attorney's Office, District of Oregon, the charges allege that Kalmesi: He is still listed as Asante's doctor. –billed Medicare and Medicaid for medical treatment he did not receive. He is also suspected of taking unnecessary steps to increase the amount charged.
“Between January 1, 2015 and January 31, 2021, Dr. Charles Kalmesi, a cardiothoracic surgeon at Asante and Asante Rogue Regional Medical Center, knowingly submitted claims to Medicare, Medicaid, and Tricare. submitted,” the release states. “(This) was performed knowingly that it did not meet reimbursement criteria or was inappropriate. , atrial septal defect closure, and cardiothoracic surgery, including the Bentall procedure.
The release said the settlement “is not an admission of liability” and that both Mr. Kalmesi and Mr. Asante deny these allegations.
MEDFORD, Ore. — Currently at the center of a police investigation into allegations of drug diversion, Asante Rogue Regional Medical Center recently settled a Medicare investigation alleging billing fraud.
The Lund Report said the investigation is related to a lawsuit alleging that hospital management ignored fraudulent claims.
“This case is based on a whistleblower lawsuit filed by one of the hospital's own physicians accusing Medford Hospital management of ignoring fraudulent claims,” the Lund Report said. “Rather, the lawsuit alleges that management targeted the physicians who reported it.”
The suit was confidentially filed in 2021, and the Federal Bureau of Investigation (FBI) investigated the allegations, according to the Lund report. After conducting an investigation, the federal government joined the whistleblower's lawsuit to “recover funds.”
According to the Lund Report, court records identify Dr. Charles Carmesi as the doctor accused of overcharging. A judge approved a settlement between the doctor and Asante in October.
The Lund report alleges that “a cardiothoracic surgeon who worked at Asante Rogue Regional Medical Center in Medford alleged that his then-coworker, Mr. Kalmesi, billed government health programs for procedures he did not perform and increased his compensation.'' He claimed that unnecessary measures were taken for the purpose.” “As a result of the allegations and the federal investigation, no criminal charges have been filed.”
According to the Lund report, the surgeon learned of Dr. Kalmesi's practice in 2019.
“The lawsuit alleges that Mr. Carmeci encouraged (surgeons) to change their billing methods to increase payment, including instructing them to “find more holes'' in patients' hearts. This is because the amount charged for surgery increases significantly,” the Lund report said.
According to the Lund report, Kalmesi also allegedly extracted three stitches from a patient and billed it as a “hernia repair.”
When the surgeon reported Kalmesi, hospital management accused him of violating medical privacy laws because “the surgeon was familiar with Kalmesi's patients,” the Lund report said.
The surgeon left Asante in 2020, according to the Lund Report.Karmechi still on the list As an Asante doctor.
Court records do not say how much the settlement amount was.
NewsWatch 12 reached out to Asante representatives for comment but did not receive a response.
