Quad Cities: MercyOne Genesis, Trinity Health Pay $4.6 Million to Settle DOJ Heart Pump Fraud Case

A Local Health System in a National Fraud Takedown

The MercyOne Genesis health system based in Davenport, Iowa, agreed to pay more than $4.6 million to settle federal allegations that it overused and overbilled for specialty heart pumps between 2016 and 2022.

The settlement was announced June 23 as part of a record $6.5 billion National Health Care Fraud Takedown led by the U.S. Department of Justice. The Quad Cities case was the largest of three Iowa cases included in the coordinated action.

What the DOJ Alleged

According to the Department of Justice news release, Mercy Health Network, Genesis Health System and Trinity Health Corp. self-reported the overuse and overbilling of a specialty heart pump device used during cardiac procedures. The partners operate the MercyOne Genesis system, which includes hospitals in Davenport and Bettendorf, Iowa, and Rock Island and Moline, Illinois.

The three entities agreed to pay more than $4.6 million to the government to resolve the allegations. A MercyOne spokesperson declined to comment on the case.

"This year's National Health Care Fraud Takedown represents the greatest whole-of-government effort to combat health care fraud in our Nation's history," U.S. Acting Attorney General Todd Blanche said in the release.

Part of a Massive Federal Crackdown

The $6.5 billion takedown involved 56 federal districts and 50 state Medicaid Fraud Control Units. Prosecutors charged 455 people and organizations in connection with false claims submitted to Medicare, Medicaid and other health care programs.

The Department of Justice said the alleged fraud and opioid abuse schemes "caused significant patient harm, including death."

Of the defendants charged, at least 90 were doctors or other licensed medical professionals.

Two Other Iowa Cases in the Takedown

The DOJ also announced two other Iowa cases as part of the same takedown:

• Dr. Eugene Cherny of Des Moines and his Heartland Plastic & Reconstructive Surgery practice are being sued by the government for allegedly submitting inflated "list price" invoices for medical supplies. Federal insurance programs reimbursed him more than $2 million, according to the release. Cherny told the Des Moines Register that "I care deeply about my patients and all my actions are for their welfare."
• Jacob Hughes of Cedar Rapids and his company Hughes Home Care, which did business as Synergy Homecare, are facing criminal charges for allegedly defrauding the Veterans Community Care Program out of more than $350,000. Prosecutors say Hughes billed for services claimed to have been provided for elderly veterans, in one case after the veteran had died. The money was allegedly used to cover gambling debts and other personal expenses.

What MercyOne Genesis Means for the Quad Cities

MercyOne Genesis is the largest health system in the Quad Cities region. It operates hospitals in Davenport, Bettendorf, Rock Island and Moline, along with numerous clinics and urgent care centers on both sides of the Mississippi River.

The settlement involves billing practices from 2016 through 2022. The specialty heart pump in question is a device used during complex cardiac surgeries to temporarily support a patient's heart function.

"While today's announcement is one of the largest on record, every arrest is a continued message to criminal actors who rob American taxpayers that you will not get away with your crimes," FBI Director Kash Patel said in the release.

Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz said in the release that the agency is "deploying advanced data analytics to expose fraud networks, freeze suspicious payments, and shut down bad actors before they can do damage to the programs that millions of Americans depend on."