7 Hospitals to Pay Over $6.3M to Resolve Kyphoplasty-Related False Claims Allegations

Seven hospitals have agreed to pay the United States more than $6.3 million to settle allegations that they submitted false claims to Medicare related to kyphoplasty procedures performed between 2000 and 2008, according to a U.S. Department of Justice release.

The hospitals were accused of performing kyphoplasty, a minimally invasive procedure used to treat certain spinal fractures, in an inpatient setting to increase Medicare billings, instead of using less-costly outpatient facilities that are just as safe in many cases.

The six hospitals to settle and the amount they have agreed to pay are as follows:
Lakeland Regional Medical Center, Lakeland, Fla. – $1,660,134
The Health Care Authority of Morgan County – City of Decatur, dba Decatur General Hospital, Decatur, Ala. – $537,892
St. Dominic-Jackson Memorial Hospital, Jackson, Miss.— $555,949
Seton Medical Center, Austin, Texas – $1,232,955
Greenville Memorial Hospital, Greenville, S.C. – $1,026,764
Presbyterian Orthopaedic Hospital, Charlotte, N.C.— $637,872
The Health Care Authority of Lauderdale County and the City of Florence, Ala., dba the Coffee Health Group, fka Eliza Coffee Memorial Hospital — $676,038

All of the settling facilities were named as defendants in a lawsuit filed in 2008 under the False Claims Act by Craig Patrick, former reimbursement manager for Kyphon, and Charles Bates, former regional sales manager for Kyphon.

The cases follow other settlements the government reached in May 2010 and May and Sept. 2009 with other hospitals for alleged kyphoplasty-related Medicare fraud claims and the government's May 2008 settlement with Medtronic Spine, Kyphon's parent. Medtronic Spine paid $75 million to settle allegations the company defrauded Medicare by counseling hospital providers to perform kyphoplasty procedures as an inpatient procedure when an outpatient procedure would have been just as safe.

Read the DOJ's release on the kyphoplasty settlements.

Read more coverage of the Kyphoplasty-related False Claims Act lawsuits.

- AHA Urges DOJ to Exercise Greater Oversight of False Claims Act Suits

- Nine Hospitals Agree to Pay More Than $9.4M to Resolve Kyphoplasty-Related False Claims Allegations

- Six Hospitals in Indiana and Alabama Pay $8.3M to Settle Medicare Fraud Allegations

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