Justice Department Settles Allegations Related to Kyphoplasty Claims

The Justice Department has reached a settlement with 14 hospitals over allegations that the hospitals submitted false claims to Medicare. The settlements will total more than $12 million, according to a press release.

The settlements resolve allegations that the hospitals, located in New York, Mississippi, North Carolina, Washington, Indiana, Missouri and Florida, overcharged Medicare between 2000 and 2008 when performing kyphoplasty, a minimally-invasive produce used to treat spinal fractures often related to osteoporosis. The operation is usually performed as an outpatient procedure, but the government suspected that the hospitals were performing the kyphoplasties as inpatient procedures in order to increase Medicare billings.

“Patients want reassurance that their health care provider is making treatment decisions based on the patient’s best interests, not an interest in maximizing profits,” Tony West, assistant attorney general for the Justice Department’s Civil Division, stated in the release. “By recovering taxpayer dollars lost to improper billing, this settlement will help support the vital public health care programs we depend on.”

The Justice Department has already reached settlements with more than 40 hospitals totaling $39 million related to false claims involving kyphoplasty.

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