Agreement Means Sutter Will Pay Millions To Settle Medicare Case

Sacramento-based Sutter Health will pay out $30 million to settle allegations that that Northern California health care provider overcharged the federal government for Medicare patient reimbursements.

The settlement agreement reached on Friday does not require Sutter Health to admit any liability, according to the U.S. Department of Justice.

Sutter Health is a nonprofit with hospitals, affiliated health care foundations, and other services in over 100 communities.

Federal officials alleged that Sutter submitted billing codes for some patients under Medicare Advantage plans, which are insurance plans managed by private organizations, according to an Associated Press report. The plans use so-called "risk codes" to determine reimbursements to the organizations for providing Medicare-covered services.

It was also alleged that Sutter submitted diagnoses that inflated the risk codes and resulted in higher paybacks.

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