A group of hospitals accused of submitting false Medicare claims have agreed to settle the federal case against them for $28 million. A total of 32 hospitals will pay the multi-million-dollar bill, which relates to inappropriate claims for a special kind of spinal fracture treatment. The U.S. Department of Justice announced the settlement on Friday.
Settling Hospitals From 15 Different States
The defendant hospitals are from 15 different states. Allegedly, they regularly billed Medicare for charges relating to a procedure called kyphoplasty administered during inpatient hospital stays. Kyphoplasty is a treatment for osteoporosis-related spinal fractures. The Justice Department claims that kyphoplasty may be performed as an outpatient procedure, and patients are not required to stay overnight in a medical facility.
Some of the hospitals that settled the lawsuit include: Martin Memorial Medical Center in Stuart, Florida, which will pay $2 million; Citrus Memorial Health System in Inverness, Florida, which will pay $2.6 million; and Cleveland Clinic in Cleveland, Ohio, which will pay $1.74 million. Hospital officials have not made themselves available to comment on the settlement.
This is not the first case over mischarges to Medicare regarding kyphoplasty. In fact, the U.S. Justice Department has obtained a total of $105 million in settlements from over 130 hospitals for the procedures.
Are You Having Trouble with Medicare?
There exist strict guidelines that apply to the types of medical procedures and circumstances that health care providers can bill Medicare for. These issues can be very complex, and sometimes mistakes are made, or differences of opinion exist between what doctors feel is necessary and what Medicare deems to be appropriate. Patients who are being denied a certain form of medical care because it does not comply with Medicare rules, may want to obtain the assistance of a Medicare benefits attorney to help them navigate the issue.
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