Fifty-five hospitals located throughout twenty-one states have agreed to pay the United States a total of more than $34 million to settle allegations that the health care facilities submitted false claims to Medicare for kyphoplasty procedures, the Justice Department announced July 2. Kyphoplasty is a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis.
In many cases, kyphoplasty can be performed safely and effectively as an outpatient procedure without any need for a more costly hospital admission. The settlements announced today resolve allegations that the settling hospitals frequently billed Medicare for kyphoplasty procedures on a more costly inpatient basis, rather than an outpatient basis, in order to increase their Medicare billings.
The following Florida hospitals were involved in the settlement:
- Mount Sinai Medical Center, Miami Beach has agreed to pay $1,846,194.00.
- Twenty-three hospitals affiliated with HCA Inc., Nashville, TN, have agreed to pay a total of $7,145,842.72. These include: Aventura Hospital & Medical Center (Aventura); Capital Regional Medical Center (Tallahassee); Doctors Hospital of Sarasota (Sarasota,); Fawcett Memorial Hospital (Port Charlotte); Fort Walton Beach Medical Center (Fort Walton Beach); JFK Medical Center (Atlantis); North Florida Regional Medical Center (Gainesville); Southwest Florida Regional Medical Center (Fort Myers); St. Lucie Medical Center (Port Saint Lucie).
- Four hospitals affiliated with Morton Plant Mease BayCare Health System, Clearwater, have agreed to pay a total of $2,378,325.45. These include: Morton Plant Hospital (Clearwater); Morton Plant North Bay Hospital (New Port Richey); Mease Dunedin Hospital (Dunedin); and Mease Countryside Hospital (Safety Harbor).
The claims resolved by these settlements are allegations only, and there has been no determination of liability.