Seven hospitals across the country have agreed to pay more than $6.3 million to settle allegations that they defrauded Medicare by performing kyphoplasty procedures in an inpatient setting to increase their billings, the Justice Department announced today.
The hospitals were defendants in a 2008 federal whistleblower lawsuit that included 18 other hospitals that have already settled with the government for more than $20 million.
The hospitals do not admit guilt but promise not to submit any future bills to Medicare for inpatient kyphoplasty procedures that should be considered outpatient cases, according to the settlement documents.
The 7 hospitals that settled most recently are:
Lakeland Regional Medical Center, Lakeland, Fla.: $1,660,134
Seton Medical Center, Austin, Texas: $1,232,955;
Greenville Memorial Hospital, Greenville, S.C.: $1,026,764;
Eliza Coffee Memorial Hospital, Florence, Ala.: $676,038;
Presbyterian Orthopaedic Hospital, Charlotte, N.C.: $637,872;
St. Dominic-Jackson Memorial Hospital, Jackson, Miss.: $555,949; and
Decatur General Hospital, Decatur, Ala.: $537,892.
In the lawsuit, whistleblowers Craig Patrick and Charles Bates, both former employees of device-maker Kyphon, described how the company's employees coached hospitals in scheduling and billing kyphoplasty as an inpatient procedures. Usually, kyphoplasty to treat a vertebral fracture is a 1- to 2-hour procedure done as day surgery. Medtronic Spine purchased Kyphon in 2007 and settled with the government for $75 million in 2008.
"These settlements show the continuing commitment by the U.S. Attorney's Office to investigate and recover any improper billings for kyphoplasty procedures," said William J. Hochul Jr., U.S. attorney for the Western District of New York, where the lawsuit was filed.
The whistleblowers will receive about $1.1 million for this part of the settlement, according to the Justice Department.
Kent Steinriede
