32 hospitals to pay $28M to settle false claims allegations related to kyphoplasty

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Thirty-two hospitals — including hospitals from systems such as Phoenix-based Banner Health, Dallas-based Tenet Healthcare and Franklin, Tenn.-based Community Health Systems — have agreed to pay the federal government more than $28 million to settle False Claims Act allegations, according to the Department of Justice.

The settlement resolves allegations the hospitals submitted false claims to Medicare for minimally invasive kyphoplasty procedures. The procedure is used to treat certain spinal fractures and can be performed safely and effectively on an outpatient basis. The government alleged the 32 settling hospitals frequently billed Medicare for kyphoplasty procedures on a more costly inpatient basis in order to increase their Medicare billings.

All but three of the hospitals that agreed to the settlement were named in a lawsuit filed under the qui tam provision of the False Claims Act, according to the DOJ.

The government has settled with more than 130 hospitals to resolve allegations they mischarged Medicare for kyphoplsty procedures.

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