More than 100 hospitals around the country have collectively paid $75 million to resolve Medicare overbilling allegations in a mammoth False Claims Act case surrounding the spinal surgery known as kyphoplasty—and there are likely more to come.
The legal battle begin in 2005, when two former managers at Kyphon accused the company of advising hospitals on ways to upcode their claims and get Medicare to pay more. But after the company settled the case, also for $75 million, federal investigators went on to target a still-unknown number of individual hospitals.
Whistle-blower attorney Tim McCormack of Phillips & Cohen in Washington said he could not comment directly on whether there are unresolved cases, but he did cite media reports that investigators have contacted hospitals other than those that have settled. “With the caveat that I can't say whether there are additional cases out there, if to the extent that there are additional cases, I wouldn't be surprised to see a hospital take it to trial,” McCormack said.