The U.S. Justice Department reached settlements totaling $8.3 million with Indiana and Alabama hospitals alleged to have overcharged Medicare for minimally invasive spine surgery.
The settlements, which do not constitute admissions of liability or wrongdoing, stem from a whistle-blower lawsuit filed under seal in Buffalo, N.Y., that alleges an unknown number of hospitals were concerned more with reimbursement than with medical necessity when they admitted patients for kyphoplasty, a procedure in which bone filler is injected into spine fractures. The procedure in many cases allegedly could have been performed appropriately and less expensively as outpatient surgery.
According to the Justice Department, 399-bed St. Francis Hospital and Health Centers, Beech Grove, Ind., agreed to pay $3.2 million; 493-bed Deaconess Hospital, Evansville, Ind., agreed to pay $2.1 million; 282-bed St. Vincent's East, Birmingham, Ala., agreed to pay $1.5 million; two-hospital St. John's Health System, Anderson, Ind., agreed to pay $826,256; 372-bed St. Vincent's Birmingham (Ala.), agreed to pay $422,748; and 349-bed Providence Hospital, Mobile, Ala., agreed to pay $381,713.
The new settlements are related to a May announcement that four-hospital HealthEast Care System, St. Paul, Minn., agreed to pay $2.3 million to resolve the same allegations.