Providence Health has agreed to pay $22.7 million to settle allegations of Medicare and Medicaid fraud, officials announced Tuesday.

The Renton, Wash.-based health system hired two neurosurgeons who allegedly falsified or exaggerated patient diagnoses and over-performed medicine at St. Mary’s Medical Center in Walla Walla between 2013 and 2017 Inappropriate or medically unnecessary procedures.

Providence received employee complaints against both surgeons and placed both on administrative leave. Both surgeons eventually resigned. But the system did not report any single doctor to the national database of practitioners, as required by federal law. This database collects information about malpractice payments and professional competence or behavior and provides the information to other systems and healthcare entities. It also did not report any of the doctors to the Washington State Department of Health.

Providence now operates under a corporate integrity agreement with the U.S. Department of Health and Human Services Office of the Inspector General, which provides for the system to have an external annual claims and clinical quality system review, provide an annual compliance report and establish a compliance committee. The settlement refers to the neurosurgeon as “Dr.” A’ and ‘Dr. B.

“Despite repeated warnings, Providence’s failure to ensure that Doctors A and B performed a safe and medically compliant surgical procedure put the patient’s life and safety at grave risk,” said U.S. Attorney for the Eastern District Vanessa R. Waldref said Washington, at a news conference. “I’m also very concerned that Providence’s decision not to report Doctor A or Doctor B to federal or state medical oversight agencies has caused both surgeons to resign from Providence and then continue to endanger patients at other hospitals.”

The two surgeons are paid based on the number of surgeries and the complexity of the operations. According to the settlement, one of the surgeons was the most productive neurosurgeon in the entire Providence system at the time, earning between $25,000 and $2.9 million a year. The settlement comes from a whistleblower complaint filed by former Providence St. Mary’s neurosurgery medical director Dr. David Yam, who left the system in June 2019, according to his Linkedin account.

Providence said in a statement that it initiated an internal review of policies, practices and procedures.

“We are committed to taking concrete, concrete action to ensure this isolated incident in Walla Walla never happens again,” wrote Michael Connors, a spokesman for Providence, which operates in seven states. 51 hospitals. “Providence has strong existing protocols and safeguards to ensure we provide quality care and is continually improving to further strengthen those protocols and safeguards.”