The Department of Justice has reached 70 settlements involving 457 hospitals in 43 states for more than $250 million related to cardiac devices that were implanted in Medicare patients in violation of Medicare coverage requirements, the Department of Justice announced today.
“While recognizing and respecting physician judgment, the department will hold accountable hospitals and health systems for procedures performed by physicians at their facilities that fail to comply with Medicare billing rules,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division. “We are confident that the settlements announced today will lead to increased compliance and result in significant savings to the Medicare program while protecting patient health.”
An implantable cardioverter defibrillator, or ICD, is an electronic device that is implanted near and connected to the heart. It detects and treats chaotic, extremely fast, life-threatening heart rhythms, called fibrillations, by delivering a shock to the heart, restoring the heart’s normal rhythm. It is similar in function to an external defibrillator (often found in offices and other buildings) except that it is small enough to be implanted in a patient’s chest. Only patients with certain clinical characteristics and risk factors qualify for an ICD covered by Medicare.
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http://www.justice.gov/opa/file/789656/download
Peninsula Regional Medical Center in Salisbury, Maryland, paid $2.9 million.
Peninsula Regional Medical Center in Salisbury, Maryland, paid $2.9 million.
So PRMC will have charge each patient a little more to cover the cost of the settlement...and we wonder why health care is so expensive.
ReplyDeleteIf not one, not 10, not 50, not 100 but 500 US hospitals are being penalized for doing what they believed was in the best interest of their patients, maybe it's time to look at just how outdated the government policy is that is governing these procedures. It's not just PRMC involved but some of the best heart hospitals in the country. That speaks volumes.
ReplyDeleteAdd that to the $30+ million they're already down this year.
ReplyDelete