Seven hospitals located throughout the southern part of United States have agreed to pay a total of $6.3 million to resolve False Claims Act allegations that they were overcharging for osteoporosis procedures, said Department of Justice (DOJ).
The DOJ said that seven hospitals in Florida, Mississippi, Texas, South Carolina, North Carolina and Alabama while performing kyphoplasty, a minimally-invasive procedure, to treat spinal fractures that are often due to osteoporosis from 2000 to 2008 had overcharged Medicare for the procedure.
In many cases, the procedure can be performed safely as a less costly out-patient procedure, but the hospitals performed the procedure on an in-patient basis in order to increase their Medicare billings, the DOJ said.
Hospitals that participate in the Medicare program must bill for their services accurately and honestly, said Tony West, Assistant Attorney General for the Department’s Civil Division.
The settlement and the amount the hospitals have agreed to pay are as follows:
Lakeland Regional Medical Center, Lakeland, Fla. - $1,660,134.49
The Health Care Authority of Morgan County – City of Decatur dba Decatur General Hospital, Decatur, Ala. - $537,892.88
St. Dominic-Jackson Memorial Hospital, Jackson, Miss. -$555,949.35
Seton Medical Center, Austin, Texas -$1,232,955.91
Greenville Memorial Hospital, Greenville, S.C. -$1,026,764.01
Presbyterian Orthopaedic Hospital, Charlotte, N.C.-$637,872.57
The Health Care Authority of Lauderdale County and the City of Florence, Ala., dba the Coffee Health Group, fka Eliza Coffee Memorial Hospital -$676,038.00.
All of the settling hospitals were named as defendants in the lawsuit, which was filed by Craig Patrick and Charles Bates in 2008 in federal district court in Buffalo, New York.
The qui tam, or whistleblower, provisions of the False Claims Act permit private citizens, called relators, to file lawsuits on behalf of the United States and share in any recovery. Patrick of Hudson, Wis., is a former reimbursement manager for Kyphon, and Bates was formerly a regional sales manager for Kyphon in Birmingham, Ala. The relators will receive a total of approximately $1.1 million as their share of the settlement proceeds.