The individual settlements with the hospitals range from $73,000 to $2.3 million.
“These hospitals put profits ahead of sound medical judgment, making decisions based on a desire to maximize Medicare reimbursement rather than on individualized assessments of medical necessity,” said William Hochul Jr., U.S. attorney for the Western District of New York in Buffalo, in the news release.
The hospitals said in the individual settlements that the “agreement is not admission of liability.”
The hospitals include Plainview (N.Y.) Hospital; Syosset (N.Y.) Hospital; North Mississippi Medical Center in Tupelo; Mission Hospital in Asheville, N.C.; Wenatchee (Wash.) Valley Medical Center; Community Hospital Anderson (Ind.); St. John's Mercy Medical Center in Creve Coeur, Mo.; Gulf Coast Medical Center and Lee Memorial Hospital in Fort Myers, Fla.; Cape Coral (Fla.) Hospital; and the system that owns Florida Hospital in Orlando, Florida Hospital Oceanside, Florida Hospital Fish Memorial and Florida Hospital Heartland Medical Center.
In total, the government has settled with the hospitals for about $40 million to resolve allegations related to Medicare claims for kyphoplasty procedures. Kyphoplasty is a minimally-invasive procedure that uses orthopedic balloons and bone cement to treat spinal fractures.
Two former employees of Kyphon, the company that manufactured the kits used in kyphoplasty, filed a whistle-blower lawsuit in 2008 in federal district court in Buffalo, N.Y. Medtronic, which acquired Kyphon in 2007, reached a $75 million settlement with the Justice Department in 2008 for allegedly telling hospitals to perform the procedures on an inpatient basis.
The Justice Department announced the first settlement with a hospital in 2009. The most recent settlement was reached in April with Rex Healthcare of Raleigh, N.C.