On September 29, 2009, the U.S. Department of Justice announced the latest settlements in its fraud enforcement initiative relating to Medicare claims for "kyphoplasty," which involves a minimally invasive procedure inserting a balloon-like device into the spine of a patient to treat certain spinal fractures. The kyphoplasty enforcement initiative originated with a False Claims Act lawsuit against Kyphon Inc., which developed kyphoplasty and marketed a kit used in the procedure. The lawsuit was filed by two former Kyphon employees-turned-whistleblowers, a reimbursement manager and regional sales manager. In May 2008, Medtronic Spine LLC, corporate successor to Kyphon Inc., paid $75 million to settle allegations that the company defrauded Medicare by counseling hospital providers to perform kyphoplasty procedures as an inpatient procedure even though the minimally-invasive procedure should have been done in many cases as an outpatient procedure. In addition to Kyphon Inc., the whistleblowers also brought suit against a number of hospitals for kyphoplasties that allegedly were improper when billed as an inpatient procedure instead of an outpatient service. The latest settlements involve six hospitals in Indiana and Alabama that agreed to pay a total of $8.3 million to settle false claims allegations related to the matter. In May 2009, three Minnesota hospitals settled Medicare fraud allegations related to kypohoplasty claims for $2.28 million, and hospitals in a number of other states are reportedly under investigation for similar allegations.