Corporate Compliance

Nine hospitals settle allegations of falsely billing kyphoplasty procedures

Compliance Monitor, May 19, 2010

Nine hospitals in seven states will pay the United States more than $9.4 million combined to resolve claims that they overcharged Medicare between 2000 and 2008, according to a Department of Justice (DOJ) press release.

Hospitals in Alabama, Indiana, Florida, Michigan, South Carolina, New York, and Minnesota allegedly performed kyphoplasty, a minimally invasive procedure that treats spinal fractures commonly caused by osteoporosis, as inpatient procedures in order to increase their Medicare reimbursement.
Nine other hospitals settled kyphoplasty fraud claims allegations in May and September of 2009. The DOJ also reached a $75 million settlement with Medtronic Spine LLC in 2008 for counseling hospitals to perform kyphoplasty procedures on an inpatient basis, instead of the safe, less costly outpatient procedure.

Craig Patrick and Charles Bates filed the lawsuit under the qui tam provisions of the False Claims Act. The two whistleblowers will split approximately $1.5 million of the settlement.

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