Six hospitals in Indiana and Alabama have agreed to pay the United States approximately $8.3 million to settle allegations that the healthcare facilities submitted false claims to Medicare, according to a Department of Justice news release.
The settlements resolve allegations that, from 2002-2008, the six hospitals overcharged Medicare each time they performed kyphoplasty, a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In many cases, the procedure can be performed safely as an outpatient surgery. According to the government, the hospitals performed the procedure on an inpatient basis in order to increase their Medicare billings.
The hospitals involved in the settlement and the amount they have agreed to pay include:
• St. Francis Hospital in Beech Grove, Ind. — $3.16 million
• Deaconess Hospital in Evansville, Ind. — $2.11 million
• St. John's Hospital System in Anderson, Ind. — $826,256
• St. Vincent's East Hospital in Birmingham, Ala. — $1.46 million
• St. Vincent's Birmingham (Ala.) Hospital — $422,748
• Providence Hospital in Mobile, Ala. — $381,713
The settlements follow the government's nearly $2.3 million settlement with three HealthEast hospitals in Minnesota in June for alleged kyphoplasty-related Medicare fraud claims and its $75 million settlement with Medtronic Spine, the parent company of Kyphon, in May 2008 for allegations the company promoted kyphoplasty as inpatient procedure to providers, according to a news release by Phillips & Cohen, the law firm representing the whistleblowers who filed the suit.
The current settlements resulted from a whistleblower suit filed in 2008 in Buffalo, N.Y., by two former Kyphon employees. The whistleblowers will receive approximately $1.4 million as their share of the various settlements.
"By keeping patients overnight, without regard to medical necessity, hospitals could seek greater reimbursement from Medicare and make much larger profits on kyphoplasty," Kathy Mehltretter, U.S. Attorney for the Western District of New York in Buffalo, said in the release.
Read the DOJ release on the kyphoplasty hospital settlements.
Read the Phillips & Cohen release on the kyphoplasty hospital settlement.
The settlements resolve allegations that, from 2002-2008, the six hospitals overcharged Medicare each time they performed kyphoplasty, a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In many cases, the procedure can be performed safely as an outpatient surgery. According to the government, the hospitals performed the procedure on an inpatient basis in order to increase their Medicare billings.
The hospitals involved in the settlement and the amount they have agreed to pay include:
• St. Francis Hospital in Beech Grove, Ind. — $3.16 million
• Deaconess Hospital in Evansville, Ind. — $2.11 million
• St. John's Hospital System in Anderson, Ind. — $826,256
• St. Vincent's East Hospital in Birmingham, Ala. — $1.46 million
• St. Vincent's Birmingham (Ala.) Hospital — $422,748
• Providence Hospital in Mobile, Ala. — $381,713
The settlements follow the government's nearly $2.3 million settlement with three HealthEast hospitals in Minnesota in June for alleged kyphoplasty-related Medicare fraud claims and its $75 million settlement with Medtronic Spine, the parent company of Kyphon, in May 2008 for allegations the company promoted kyphoplasty as inpatient procedure to providers, according to a news release by Phillips & Cohen, the law firm representing the whistleblowers who filed the suit.
The current settlements resulted from a whistleblower suit filed in 2008 in Buffalo, N.Y., by two former Kyphon employees. The whistleblowers will receive approximately $1.4 million as their share of the various settlements.
"By keeping patients overnight, without regard to medical necessity, hospitals could seek greater reimbursement from Medicare and make much larger profits on kyphoplasty," Kathy Mehltretter, U.S. Attorney for the Western District of New York in Buffalo, said in the release.
Read the DOJ release on the kyphoplasty hospital settlements.
Read the Phillips & Cohen release on the kyphoplasty hospital settlement.