DOJ settles with 51 hospitals for $23 million in Medicare-related case

By Mark Iandolo | Feb 19, 2016

WASHINGTON (Legal Newsline) – In a landmark health care case, the Department of Justice reached agreements with 51 hospitals in 15 states for more than $23 million over alleged Medicare violations related to certain cardiac device implementation.

These settlements are the final stage of a national case, where the DOJ looked into the practices of hundreds of hospitals. Specifically, it looked at how these hospitals billed Medicare. The current settlements add to existing ones and bring the total to more than 500 hospitals and $280 million.

“These settlements demonstrate the department’s continued vigilance in pursuing hospitals and health systems that violate Medicare’s national coverage rules,” Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division, said. “We will hold accountable those who do not abide by the government’s rules in order to protect the federal fisc and, more importantly, patient health.”

An implantable cardioverter defibrillator, or ICD, is an electronic device that is put into the body near the heart to detect and treat fast, life-threatening heart rhythms. The DOJ alleges that these devices were implanted in people in violation of Medicare coverage requirements.

“We will not stand idly by while Medicare coverage rules are ignored,” Inspector General Daniel R. Levinson of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) said. “OIG worked closely with the Department of Justice to ensure such violators made substantial payments to settle these false billing claims.”

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