51 hospitals pay $23M for alleged overuse of cardiac devices

The Department of Justice has inked a deal for more than $23 million with 51 hospitals across the nation — including Cleveland Clinic and San Francisco-based Dignity Health hospitals — to settle False Claims Act allegations related to the implantation of cardiac devices in Medicare patients.

The claims made against the hospitals stem from a cardiac device called an implantable cardioverter defibrillator. Only patients with certain clinical characteristics and risk factors qualify for an ICD covered by Medicare, and Medicare coverage for the device is governed by a National Coverage Determination.

The NCD provides that ICDs, which cost approximately $25,000, should not be implanted in patients who have recently suffered a heart attack or recently had heart bypass surgery or angioplasty. There is a 40-day waiting period to implant an ICD in a heart attack patient and a 90-day waiting period for bypass/angioplasty patients. During these waiting periods, the NCD expressly prohibits implantation of ICDs.

The federal government alleged each of the settling hospitals implanted ICDs during the waiting periods set by the NCD from 2003 to 2010, according to the DOJ.

These settlements represent the final stage of a nationwide investigation into the practices of hundreds of hospitals. Last October, 457 hospitals across the country agreed to pay the federal government $250 million to settle allegations related to the overuse of ICDs.

"The settlements announced last October and today demonstrate the Department of Justice's commitment to protect Medicare dollars and federal health benefits," said U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida. "In terms of the number of defendants, this is one of the largest whistle-blower lawsuits in the U.S. and represents one of the office's most significant recoveries to date."

A full list of the settling hospitals can be found here.

More articles on healthcare industry lawsuits:

NJ physician accused of submitting false claims settles for $5.25M
5 latest healthcare industry lawsuits, settlements
Miami physician pleads guilty to role in $20M Medicare fraud scheme

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