55 Hospitals to Pay $34M to Resolve Charges of Improper Kyphoplasty Billing

Fifty-five hospitals across 21 states have agreed to pay more than $34 million combined to resolve alleged false claims to Medicare for kyphoplasty procedures.

Kyphoplasty is a minimally invasive procedure used to treat certain spinal fractures, which are often due to osteoporosis. In many cases, the procedure can be performed effectively and safely in the outpatient setting, which is less costly than an inpatient procedure.

The hospitals are resolving allegations that they frequently billed Medicare for kyphoplasties on an inpatient basis to boost their Medicare reimbursements. The Department of Justice has now reached settlements with more than 100 hospitals totaling approximately $75 million to resolve allegations they mischarged Medicare for kyphoplasty procedures.  

Below is a listing of the latest settlements, beginning with the largest monetary amount. A complete listing of individual hospitals under each system settlement can be found here.

• Twenty-three hospitals affiliated with Nashville, Tenn.-based Hospital Corp. of America — $7.15 million.

• Atrium Medical Center (Middletown, Ohio) — $4.23 million

• Five hospitals affiliated with Livonia, Mich.-based Trinity Health — $3.91 million

• Four hospitals affiliated with Clearwater, Fla.-based Morton Plant Mease BayCare Health System — $2.38 million

• Six hospitals affiliated with Brentwood, Tenn.-based LifePoint Hospitals —  $2.52 million

• Two hospitals affiliated with Knoxville, Tenn.-based Covenant Health — $1.85 million

• Mount Sinai Medical Center (Miami Beach, Fla.) —$1.85 million

• Altru Health System (Grand Forks, N.D.) — $1.49 million

• Cedars-Sinai Medical Center (Los Angeles) —$1.49 million

• Wayne Memorial Hospital (Goldsboro, N.C.) — $1.25 million

• Trover Health System (Madisonville, Ky.) — $1.16 million

• Two hospitals affiliated with Newark, Del.-based Bayhealth Medical Center — $1.12 million

• The Queen's Medical Center (Honolulu) —$1.06 million

• Des Peres Hospital (St. Louis) — $900,000

• Three hospitals affiliated with Memphis, Tenn.-based Baptist Memorial Health Care — $691,168

• St. Anne's Hospital (Fall River, Mass.) — $552,745

• New England Baptist Hospital (Boston) —$374,814

More Articles on Hospital Settlements:

University of Louisville Hospital to Pay $2.8M for Alleged False Billing
Westerly Hospital to Pay $500k for Allegedly Improper Physician Arrangements
Prime Settles Alleged HIPAA Violation

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