Fourteen hospitals operated by Iasis Healthcare are under scrutiny in a yearslong nationwide investigation into the suspected overuse of implantable defibrillators.
The Franklin, Tenn.-based company disclosed information about the investigation in a filing with the Securities and Exchange Commission on Thursday.The company has also disclosed the investigation in previous filings.
"As indicated in our SEC filings over the past several years, as with many other hospital operators nationwide, we have been working cooperatively with the government to resolve this matter," an Iasis spokeswoman said in a statement. "We believe that we have demonstrated that a substantial majority of ICD procedures at our hospitals that are subject of this review were medically necessary and billed appropriately. We believe that regardless of the procedure, we provide our patients with all necessary care in a high-quality, cost-effective and appropriate manner."
The U.S. Justice Department gave Iasis a list in 2011 of 194 procedures involving implantable cardioverter defibrillators at the hospitals under investigation, according to the filing.
“We are cooperating fully with the government and, to date, the DOJ has not asserted any claim against our hospitals,” Iasis said in the filing. Attempts to reach Iasis for additional comment were not immediately successful Friday morning.
Iasis believes at least 131 of the procedures were properly documented for medical necessity and appropriately billed. “We continue to provide support for the remaining 63 of these cases that could have some likelihood of enforcement by the DOJ,” according to the Iasis filing.
Iasis is the sixth-largest for-profit hospital chain in the country. It operates 15 acute-care hospitals, according to its website.
So far, at least two hospital systems have settled with the government over allegations related to the same investigation, which started more than four years ago and may involve hundreds of hospitals.
Irvine, Calif.-based St. Joseph Health disclosed late last year that it had agreed to settle with the Justice Department without admitting liability. The first settlement in the investigation was between the government and MedCath Corp., a now-defunct chain of heart hospitals.
The investigation has raised the ire of some physicians, who say Medicare's coverage rules for the devices conflict with other medical guidelines.
The devices cost $40,000 or more, and their use increased after Medicare changed its rules in 2005 to allow patients to get them for primary prevention of arrhythmia. The rules, however, say the devices can't be implanted within 40 days of a heart attack or 90 days of bypass surgery. Many doctors have implanted them outside the parameters of those rules.
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