Thirty-two hospitals have agreed to pay over $28 million to resolve outstanding False Claims Act allegations, the U.S. Department of Justice (DOJ) announced on December 18, 2015. The hospitals were accused of submitting false claims to Medicare relating to kyphoplasty procedures billed on an inpatient, rather than outpatient basis.
Kyphoplasty procedures are typically used to treat vertebrae fractures associated with osteoporosis. The government maintains that kyphoplasty procedures are minimally invasive and therefore can generally be safely and effectively performed on an outpatient basis. The hospitals were allegedly performing and billing such services at a higher level of care than was necessary.
To date, the DOJ has similarly settled with more than 130 hospitals across the country, with payments approximating $105 million. The majority of the hospitals in Friday’s settlement were defendants in a qui tam whistleblower lawsuit brought in federal district court in Buffalo, New York.
The DOJ’s press release on the settlement is available here.