457 hospitals settle for $250 million over improper implantable cardioverter defibrillator surgeries
The biggest hospital chain settlements are HCA, at $15.8 million; Ascension Health at $14.9 million; and Community Health Systems at $13 million.
Nearly 500 hospitals have been ordered to pay the government more than $250 million to resolve allegations they allowed cardiac devices to be implanted in Medicare patients who were not eligible for the procedure, according to an Oct. 30 announcement from the Department of Justice in Florida.
Authorities said they reached 70 settlements involving 457 hospitals in 43 states for more than $250 million.
The biggest hospital chain settlements are HCA, at $15.8 million; Ascension Health at $14.9 million; and Community Health Systems at $13 million.
The implantable cardioverter defibrillator cost about $25,000.
Federal guidelines state an ICD should not be implanted in patients who have recently suffered a heart attack or recently had heart bypass surgery or angioplasty, according to authorities. There is a mandatory waiting period.
The Department of Justice alleged that from 2003 to 2010, each of the settling hospitals implanted ICDs during the periods prohibited by federal standards.
Authorities charged the hospitals under the False Claims Act, but said the claims resolved by the settlement are allegations only and do not determine liability.
Most of the settling hospitals were named in a whistleblower lawsuit filed in federal district court in the Southern District of Florida by Leatrice Ford Richards, a cardiac nurse, and Thomas Schuhmann, a healthcare reimbursement consultant, according to the Justice Department.
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The whistleblowers have received more than $38 million from the settlements. The Department of Justice is continuing to investigate additional hospitals and health systems, it said.
"Guided by a panel of leading cardiologists and the review of thousands of patients' charts, the extensive investigation behind the settlements was heavily influenced by evidence-based medicine," said U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida. "In terms of the number of defendants, this is one of the largest whistleblower lawsuits in the United States and represents one of this office's most significant recoveries to date."
Other hospitals named include those within the following health systems: Adventist, Advocate, Allina, Ashland Hospital Corp., Banner, Baptist Healthcare, Baptist Memorial Healthcare, Baptist St. Anthony's, Baylor, Charleston Area Medical Center, Catholic Health East, Catholic Health Initiatives, Christiana Care, CHRISTUS, Cooper Health System, Deborah Heart and Lung Center, Ector County Hospital District, Emory Healthcare, Florida Health Sciences Center, Franciscan Alliance, Franciscan Missionaries of Our Lady, Hackensack University Medical Center, Health Management Association, IASIS Healthcare Corp., Indiana Heart Hospital, Iowa Health System, IHC Health Services, McLaren Health Care, Medical Center of Central Georgia, MedCath, MedStar, Memorial Health System, Memorial Hermann, Mercy Health, North Mississippi Health System, New York and Presbyterian Hospital, Ohio State University, Oklahoma Heart Hospital, Providence Health System, Queen's Medical Center, Robert Wood Johnson Health Care, Scripps Health, SSM Health Care, St. Bernards Medical Center, St. Joseph, Saint Vincent, Sutter Health, Tenet Healthcare, Texas Health Resources, Trinity Health, Universal Health Services, UPMC, Valley Health System, WakeMed, William Beaumont Hospital, and Winthrop University Hospital.
Here is the full list of hospitals that paid settlements:
Twitter: @SusanJMorse
