CINCINNATI (Legal Newsline) -- West Chester Memorial in Cincinnati has agreed to a $4.1 million settlement after allegations of billing federal health care programs for medically unnecessary spinal surgeries, the U.S. Department of Justice recently announced.
The hospital will pay the settlement to resolve allegations of submitting claims to Medicare and Medicaid for unnecessary spinal surgeries completed between 2009 and 2013 by Dr. Abubakar Atiq Durrani. He was arrested in July 2013 and charged with health care fraud. The surgeries were performed on patients residing in Ohio and Kentucky.
“Hospitals have a responsibility to ensure that services provided at their facilities are medically necessary and appropriate before they bill federal health care programs for those services,” Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division, said. “When providers charge for medically unnecessary services, we will aggressively seek remedies under the False Claims Act.”
The state of Ohio and commonwealth of Kentucky will receive approximately $72,000 of the settlement for Medicaid claims that were jointly funded between the states and federal government.
“Federal health care programs cover only those procedures that are medically necessary,” U.S. Attorney Carter M. Stewart of the Southern District of Ohio said. “The U.S. Attorney’s Office is committed to pursuing providers that seek payment for unnecessary medical procedures.”
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