About 50 hospitals are forking over a total of $23 million to the federal government to put an end to an investigation into improper Medicare billing.
The investigation focused specifically on hospitals charging Medicare for implanting cardiac defibrillators in patients too soon after certain major cardiac events.
Medicare will only reimburse providers for such devices if they are implanted at least 40 days after a heart attack or 90 days after bypass surgery.
According to federal officials, the rules are intended to prevent unnecessary implantations of the devices, which typically cost about $25,000.
“We will hold accountable those who do not abide by the government’s rules in order to protect the federal fiscal and, more importantly, patient health,” said Benjamin C. Mizer, head of the Department of Justice Civil Division, in a statement announcing the deal.
But some doctors argue that some patients are better off with the implantations sooner, and that forgoing them could risk lives.
Not only did the deal between the hospitals and the feds not include an admission of wrongdoing on the part of the hospitals or doctors involved, but some of the hospitals insisted that they will pursue the same medical strategy in the future if they believe it is necessary.
"While we believe that the charges were appropriate, we chose to settle the matter rather than engaging in expensive litigation that distracts from our mission," the Cleveland Clinic, which paid $1.6 million as part of the settlement, said in the statement.
The news comes after a far more significant settlement was announced involving improper charges to Medicaid by Wyeth, a subsidiary of Pfizer.
In that case, Pfizer agreed to pay $785 million for charging Medicaid programs more than private sector customers, which is illegal.
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