By U.S. Attorney’s Office, Northern District of California, U.S. Department of Justice

SAN FRANCISCO – Sutter Health, a Sacramento-based health care services provider, and its affiliate Sutter Bay Hospitals, the successor to Sutter East Bay Hospitals dba Alta Bates Summit Medical Center (collectively Sutter Health), agreed to pay more than $13 million to settle allegations that it violated the federal False Claims Act by billing the United States for toxicology screening tests performed by outside labs, announced United States Attorney Stephanie M. Hinds; Federal Bureau of Investigation San Francisco Special Agent in Charge Robert K. Tripp; Office of Personnel Management Office of Inspector General (OPM OIG) Special Agent in Charge Amy K. Parker; Department of Health and Human Services Office of Inspector General (HHS-OIG) Special Agent in Charge Steven J. Ryan; Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS) Western Field Office Special Agent in Charge Bryan D. Denny; and the Defense Health Agency (DHA).  Sutter Health DOJ Settlement Agrmt 10.17.2022

“Sutter Health agreed to pay $13 million to settle allegations that it billed government health programs for lab tests performed by others,” said U.S. Attorney Stephanie M. Hinds. “Government health care programs must be protected, and this office will investigate and pursue health care providers that fail to provide the services paid for by public health care programs.”

“Investigating health care fraud and abuse is a priority for the FBI,” said FBI San Francisco Special Agent in Charge Robert K. Tripp. “These cases are often worked in conjunction with our federal law enforcement partners, and this settlement is a great example of the multi-agency investigative team’s hard work to protect the integrity of the Federal Employees Health Benefits Program.”

“The OPM OIG is committed to protecting the Federal Employees Health Benefits Program from fraudulent claims,” said OPM OIG Special Agent in Charge Amy K. Parker. “I applaud the dedicated team for their effort in securing today’s settlement.”

“When medical providers charge federal health care programs for services that other providers actually performed, the integrity of these programs is undermined,” said HHS-OIG Special Agent in Charge Steven J. Ryan. “Working with our law enforcement partners, we will continue to uproot and investigate such schemes.”

“Today’s announced outcome concludes a collaborative effort to hold Sutter Health accountable for its improper billing practices that harmed our health care system, including the Department of Defense’s TRICARE program,” said DCIS Western Field Office Special Agent in Charge Bryan D. Denny. “DCIS will continue to work closely with our law enforcement partners to protect the integrity of the health care system.”

“We commend the Department of Justice, the U.S. Attorney’s office, and the other state and federal agencies for their commitment to justice,” stated the Defense Health Agency. “Their efforts protect taxpayer dollars to ensure our service members, veterans and their families continue to receive the highest level of medical care.”

The United States contends in the civil settlement agreement signed by Sutter Health that under the terms of a contract which the Sutter Health hospital Alta Bates Summit Medical Center entered into with Navigant Network Alliance, LLC, Navigant referred urine toxicology specimens obtained from physicians and laboratories across the country to Sutter. Sutter submitted bills, or caused bills to be submitted, for reimbursement of the qualitative and quantitative testing it performed on the specimens. The United States asserts that Sutter did not perform the quantitative testing on thousands of specimens referred under the agreement and that these quantitative tests were instead performed by third-party labs. The United States alleges that Sutter nevertheless sought reimbursement for the tests. In the settlement agreement, the United States contends that between August 1, 2016, and June 30, 2017, Sutter billed for urine toxicology tests it did not perform and was paid for the testing by the Federal Employees Health Benefits Program, Medicare, Medicaid, and Tricare.

Sutter agrees in the settlement agreement to pay $13,091,452 to settle the false claims allegations. Of that amount, Sutter has already paid more than $6.5 million to the United States. Sutter agrees to pay the remaining amount of approximately $6.5 million to the United States within 30 days. The settlement agreement resolves the civil law claims that the United States might have brought based upon these allegations.

This matter is being handled by Assistant United States Attorney David DeVito, with assistance from Garland He, Jonathan Birch, Lillian Do, and Alan Lopez. The matter is the result of a coordinated investigation between the U.S. Attorney’s Office for the Northern District of California and the FBI, OPM OIG, HHS-OIG, DCIS, and the DHA.

The investigation and resolution of this matter illustrate the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The civil settlement agreement is neither an admission of liability by Sutter Health nor a concession by the United States that its claims are not well founded.

 

A comprehensive package to address concerns of students, families, educators

Washington, D.C. – Today, Thursday, Sept. 29, 2022, Congressman Mark DeSaulnier (D, CA-11), Chairman of the House Education and Labor Committee’s Subcommittee on Health, Employment, Labor, and Pensions, and Education and Labor Committee Chairman Robert C. “Bobby” Scott (VA-03) announced House passage of the Mental Health Matters Act (H.R. 7780), legislation they authored to help confront the mental health crisis by increasing access to support, services, and resources for children, students, workers, and families. The bill passed the U.S. House of Representatives by a vote of 220-to-205 with all Democrats and one Republican voting in favor.

“From children and young adults experiencing an uptick in mental health challenges to educator burnout, our country is experiencing a mental health and substance abuse crisis. As someone who lost their father by suicide, I am proud to have led this comprehensive approach to strengthen mental health resources for students, educators, and workers with Chairman Scott,” said DeSaulnier. “I urge the Senate to pass this legislation so we can combat the mental health crisis in this county and ensure everyone has the resources they need to live happy, healthy, and fulfilling lives.”

“The COVID-19 pandemic exacerbated the mental health crisis among students, workers, and families. As a result, educators have been forced to play an outsized role in supporting and responding to students’ mental health needs, leading to increased depression and trauma among educators. Moreover, nearly half of the U.S. workforce now suffers from mental health issues since the COVID-19 pandemic began. In response to the national mental health crisis, I am proud to stand in strong support of the Mental Health Matters Act led by Congressman Mark DeSaulnier. The Mental Health Matters Act delivers the resources that students, workers, and families need to improve their well-being,” said Chairman Scott.

The Mental Health Matters Act takes comprehensive steps to address our nation’s mental health and substance abuse crises by strengthening school-based behavioral health care, bolstering mental health parity protections, and ensuring access to mental health and substance use disorder benefits for workers and families.

Specifically, this bill would:

• Increase the number of mental health professionals serving in high-need schools and help to build a pipeline of school-based mental health services providers;
• Help state educational agencies recruit and retain school-based mental health services providers at high-need public schools;

• Require institutions of higher education to increase transparency around the accommodations process and allow incoming students with existing documentation of a disability to access disability accommodations;

• Increase students’ access to evidence-based trauma support and mental health services through innovation by linking schools and districts with local trauma-informed support and mental health systems;

• Require the Department of Health and Human Services to identify evidence-based interventions to improve the health of children and staff in Head Start programs, and help Head Start agencies implement these interventions;

• Strengthen the capacity of the Department of Labor to ensure that private, employer-sponsored group health plans provide mental health and substance use disorder benefits under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Employee Retirement Income Security Act (ERISA); and

• Strengthen the ability of people with private, employer-sponsored health and retirement plans to hold plan sponsors accountable when they are improperly denied mental health and substance use disorder benefits.

DeSaulnier represents most of Contra Costa County in the U.S. House of Representatives.

The National Committee for Quality Assurance (NCQA), the national evaluator of health insurance plans, has recognized Contra Costa Health Plan (CCHP) as among the best in California for patient experience and the quality of care it provides.

Among health maintenance organizations (HMO) offering Medi-Cal, none rated higher than CCHP on NCQA’s annual report card, which gave the Plan 4 out of 5 stars and exceptionally high marks for patient experience and preventative care.

“We are especially proud of our rating for patient experience, because it comes directly from the people we care for,” Contra Costa County Health Director Anna Roth said. “It shows how strong our county’s healthcare delivery system is​, from the medical professionals taking care of county residents to the hospitals and medical clinics serving our community.”

Contra Costa Health provides high-quality, affordable coverage through CCHP, which will mark 50 years of service in 2023, making it the nation’s first federally qualified, state-licensed, county-sponsored HMO.

CCHP’s high marks and recognition by NCQA are a direct result of the exemplary care and patient support provided by Contra Costa Regional Medical Center and affiliated health centers, and our Public Health and Behavioral Health divisions, which touch about 243,000 members, including 235,000 Medi-Cal enrollees.

CCHP earned high marks among patients for the quality of care from primary care doctors, overall quality of care, and preventative care. No other Medi-Cal HMO rated higher.

NCQA is a national nonprofit organization that accredits and evaluates a wide range of healthcare organizations and medical practices. A searchable database of its report cards is available at reportcards.ncqa.org.

Visit contracostahealthplan.org to learn more about CCHP, including how to enroll if you need healthcare, or call 1-800-211-8040 weekdays.

 

It’s not too late to sign up for the Antioch Police Officer’s Associations Poker Tournament Fundraiser for Jax Duggar! Jax is the son of Officer Scott Duggar and has stage 4 kidney disease.

Sign up today at https://antiochpoa.org/news/the-dugger-family-poker-night

The senior honor student connected to the program as a delegate of The Congress of Future Medical Leaders

Daughter of Dr. Lance and Treasure Miller

By Allen D. Payton

Brentwood resident Presley Miller, a senior at Freedom High School in Oakley, California recently returned from a two-week summer honors program in Dar es Salaam, Tanzania with FutureDocs Abroad for high school and undergraduate students who aspire to a career in the medical field.

She was selected for the opportunity through her participation as a delegate to The Congress of Future Medical Leaders, a nationally recognized high school honors program of the National Academy of Future Physicians and Medical Scientists. Students must have a minimum 3.5 GPA to qualify. Miller’s GPA is 4.0. She attended the Congress which was held via Zoom in June 2021.

A separate group of students went to Vietnam during the same weeks. Miller chose Tanzania to apply for “because it was in Africa where I’ve never been.”

FutureDocs Abroad is an honors-only program, of the National Leadership Academies, that allows qualified high school students a once-in-a-lifetime opportunity to gain real-life experience and access what only third and fourth-year medical students can in the United States. The purpose of this internship is to honor, inspire, motivate, and direct the top students in the country, to stay true to their dream and, after the program, to provide a path, plan, and resources to help them reach their goal.

It puts passionate and qualified students into an intense medical environment overseas, where every single day it allows them an opportunity to experience, now what they’ve only been able to imagine.

FutureDocs Abroad was founded on the belief that strong emotional intelligence is the cornerstone of student success and is committed to supporting students in their development. The National Leadership Academies also recognizes that prospective talent must be identified at the earliest possible age and help must be given to these students to acquire the necessary experience and skills to take them to the doorstep of vital careers as leaders and in the fields of medicine and the sciences.

“It was exciting to be able to personally experience international medicine and learn the culture of Tanzania, while creating lifelong friendships and memories!” said Miller. “It was an experience of a lifetime.”

During the program, she joined students from across the U.S. and spent time observing surgeries taking place in the operating room, with the surgeon explaining the procedure as it was being performed. Miller also spent time in the gross anatomy lab with a professor, learning about the anatomy and proper dissection of human cadavers and practicing dissection techniques on animal parts. In addition, she shadowed physicians in the emergency room, clinics, and wards in over a dozen areas of specialty, including pediatrics, oncology, surgery, orthopedics, OB/GYN, and more.

“I got to observe a C-section, cesarean, and watch a baby take his first breath,” Miller shared as her favorite part of the trip. That gave her the desire to focus on “neurosurgery and work in pediatrics.”

One of about 50 students on the trip, she was the only one from Freedom High and encourages other students to participate, as well.

“If you have the opportunity to be a part of The Congress and be able to sign up and be selected to go on this trip, other students should do it. I would do it again, personally,” Miller stated. “If other kids in our area are able to experience this it will be amazing.”

“It took about 30 hours of travel each way,” she shared. “We had to first fly to New York to meet up with the group and fly together from there.”

They landed in Dubai after a 12 or 13-hour flight, followed by a five-hour flight to Tanzania, Miller explained.

“But coming home it was longer due to layovers,” she added.

Asked how she learned about the program she explained, “I got a certificate in the mail from a doctor, Stephen Mitchell, the dean of Georgetown Medical School in May 2021.”

“I was like, ‘what is this?’” Miller said. “It was a selection for the Award of Excellence from the Congress of Future Medical Leaders and an invitation to attend it.”

There’s a fee to participate in the program. “But part of it was covered by a sponsor who paid for everyone,” she shared.

As part of the Congress, Miller did extra course work to earn one college credit. She has also been taking high school courses, more than required, for a degree in medicine.

“I took anatomy and physiology this last year and taking AP biology and chemistry, this year,” Miller shared.

Asked about her college plans, she said, “my goal is to go to UCLA, but I’m open to anything, anywhere for undergraduate school that would be a good connection to medical school, whatever God has planned for me.”

Miller is also a varsity cheerleader at Freedom High and the daughter of Antioch chiropractor, Dr. Lance and Treasure Miller.

Asked if she was inspired by her father being a chiropractor, Miller said, “Yes. Growing up around it and always being in that environment of the medical field.”

She works with her dad and mom in the office during the summer. Miller’s older sister Haley is starting chiropractic college in the fall.

“As a parent, we’re proud of our daughter’s dreams and inspired by her desire to enter the medical field in neurosurgery,” dad, Lance stated. “When she was younger, Presley wanted to find a cure for Alzheimer’s because my Aunt Pam died of it at an early age.”

“We were a little nervous about her going over there in another country for two weeks, but excited at the same time,” he shared. “Thank God for technology because we were able to speak with her every day on WhatsApp and Facetime.”

Presley’s mom, Treasure spoke about the trip and her interest in medicine from early childhood.

“I took her to New York, and we met with the program at JFK airport, then they took her from there to Tanzania. We had to participate in Zoom meetings before she went,” she shared. Presley said they got to New York City two days before and went shopping in Manhattan.

“I’m not sure how they got her information, but I’m sure it was during COVID when the students went online and she was showing her interests in college and they got her information,” Treasure explained.

“She’s always known since she was five that she wanted to be a neurosurgery,” her mom, continued. “I asked, ‘why neurosurgery?’”

“She said ‘you, know, Mom, everyone needs a brain and I’ll never be out of a job,’” Treasure stated.

“I’m extremely proud of her and I know God has a plan for her in her life and has definitely set her up for this,” Presley’s mom, said. “It was very hard for me to let her go to a third world country at 17-years-old. So, I had to really give it to God and pray about it and let her go and trust she would be fine.”

“She was 13 hours ahead,” Treasure stated. “So, when her day was ending my day was starting,” and vice versa,

“I’ve always known since she was very little that God gave her this gift to heal people, kind of like her dad, to heal people with his hands,” she continued. “But she’s going down a different road. They work together. You can’t live without your brain or your spine. She’s a different child, a very old soul, very mature for her age and always has been.”

“She does work hard at it. But she’s very dedicated,” Treasure added.

About The Congress of Future Medical Leaders

High-achieving and deserving high School students are selected to become Delegates of the Congress of Future Medical Leaders by parents, teachers, and other educational avenues. Student Delegates are screened through an application process that includes GPA verification. Academically superior high school students are honored for their dedication, talent, and leadership potential in medicine.

During the Congress, Delegates hear from the world’s leading medical pioneers, groundbreaking researchers, young prodigies who are carving the way for the future of medicine and medical technology, and from patients who have had their lives changed (or saved) by medicine.

The stage is graced by the greatest living minds from different areas of medicine, medical technology and engineering, research, and science—some that Delegates may not know exist! They share insights into who they are, what they do, their successes, failures, and practical advice for Delegates.

For more information, visit www.TheNationalLeadershipAcademies.com or call (888) 986-6563.

 

“Nearly 20,000 gallons per minute”

By Allen D. Payton

After burning and filling the air over Antioch and Pittsburg with smoke for almost two months the Marsh peat fire in Pittsburg appears to be extinguished. (See related article)

In a post on their Facebook page on Saturday, July 23, the Contra Costa County Fire Protection District (Con Fire) reported that they have “ended flooding today that has, for 7 days, with help from CC Water Dist. & the property owner, put some 200 M gallons of water on the Marsh peat fire in Pittsburg. No apparent hotspots or smoke remain, though we continue to monitor for flareups.”

On Friday, they reported that the “Marsh peat fire flooding is proving extremely effective with only small areas continuing to put off some limited smoke today. Flooding continues at nearly 20,000 gallons per minute. Con Fire is hopeful of complete extinguishment in coming days.”

Sign up today if you are looking for some good music and a great total body workout. To register click here.

Presented by City of Antioch Recreation Department