Federal prosecutors are letting Texas hospitals off the hook in their nationwide probe of how hospitals bill Medicare for certain laboratory tests.
Last week at least 50 Texas hospitals received letters from their local U.S. attorneys' offices saying the government has decided not to pursue laboratory unbundling cases against them.
"In every case, the hospitals were given the benefit of the doubt, and ambiguous data was viewed in the light most favorable to the hospitals," the letters said.
Charles Bailey, general counsel for the Texas Hospital Association, said he expected 300 of the state's 450 acute-care hospitals to be exonerated.
"We're very happy," Bailey said. "The government hasn't told us exactly why they are doing this, but our guess is that they ultimately don't have enough to move forward."
Texas hospitals that already have settled laboratory unbundling charges will have the opportunity to rescind their agreements and receive a refund from the government, Bailey said.
Bailey did not know exactly how many of the 300 hospitals had settled but said he had heard from about 10 hospitals that did sign agreements to resolve the charges. Bailey did not know how much they paid in their settlements.
The U.S. attorneys' offices will refer all matters to the proper Medicare fiscal intermediary for further review, the letters said.
The government kicked off its Project Bad Bundle laboratory-test billing probe in 1996. To date, the government has entered more than 200 settlements for a total of $42 million.
The government also scaled back laboratory unbundling investigations in Illinois and Minnesota (July 13, p. 6). However, federal investigators still are pursuing cases in other states, including Missouri, Bailey said.