A doctor at the medical center has been accused of performing unnecessary procedures to drive up Medicare and Medicaid bills.
Update, January 16 at 10:20 a.m.: Asante Health System and Dr. Charles Carmeci paid $430,000 to settle Medicare fraud allegations.
According to a press release from the U.S. Attorney’s Office in Oregon, allegations allege that Carmesi — who is still listed as a doctor at Asante — billed Medicare and Medicaid for medical procedures he did not perform. He also allegedly took unnecessary actions to raise bills.
“Between January 1, 2015 and January 31, 2021, Asante and Dr. Charles Carmesi, a cardiothoracic surgeon practicing at Asante Rouge Regional Medical Center, submitted claims for payment to Medicare, Medicaid, and TRICARE,” the statement read. “(This was) for cardio-thoracic surgeries including ablations, PleurX catheter placement, pericardiectomy, mediastinal mass resection, patent foramen ovale, atrial septal defect closure, and Bentall procedures, knowing that they did not meet reimbursement criteria or were inappropriate “
The statement said the settlement “is not an admission of liability” and that Carmesi and Asante denied the accusations.
MEDFORD, Ore. – Asante Rouge Regional Medical Center, now the center of a police investigation into drug diversion allegations, has settled a Medicare investigation alleging billing fraud.
According to Lund’s report, the investigation is linked to a lawsuit alleging that hospital management ignored billing fraud.
“This was based on a lawsuit filed by a hospital physician who accused management at Medford Hospital of ignoring billing fraud,” Lund’s report said. “Instead, the lawsuit alleged, the department targeted the doctor who reported the matter.”
The lawsuit was filed secretly under seal in 2021, and the FBI investigated the allegations, Lund’s report said. After the investigation, the federal government joined the whistleblower lawsuit to “recover the money.”
Court records identify Dr. Charles Carmesi as the doctor accused of overbilling, Lund’s report said. A judge approved a settlement between the doctor and Asante in October.
“The cardiothoracic surgeon who worked at Asante Rouge Regional Medical Center in Medford claimed that his then-co-worker, Carmesi, billed government health programs for procedures he did not perform and performed unnecessary procedures to increase his compensation,” Lund’s report said. “No criminal charges resulted from these allegations and the federal investigation.”
The surgeon discovered Carmesi’s practices in 2019, Lund’s report said.
“The lawsuit alleges that Carmesi encouraged (the surgeon) to change billing practices to increase payments and, for example, told him to find more holes in a patient’s heart because closing them would significantly increase the amount he could pay for surgery.” The Lund report said.
Lund’s report stated that Carmesi also removed three stitches from a patient and described it as a “hernia revision.”
When the surgeon reported Carmisi, the Lund report said, hospital management allegedly accused him of violating medical privacy laws because “he knew too much about Carmisi’s patients.”
The surgeon left Asante in 2020, Lund’s report said. Carmesi is still listed as a doctor at Asante.
Court records did not say how much money was in the settlement.
NewsWatch 12 reached out to Asante representatives for comment and has not received a response.