55 Hospitals to Pay $34M to Settle False Claims Act Allegations

BUFFALO – U.S. Attorney William J. Hochul, Jr. announced today that 55 hospitals located throughout 21 states have agreed to pay the United States a total of more than $34 million to settle allegations that the healthcare facilities submitted false claims to Medicare for kyphoplasty procedures.

Kyphoplasty is a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In many cases, kyphoplasty can be performed safely and effectively as an outpatient procedure without any need for a more costly hospital admission. The settlements announced today resolve allegations that the settling hospitals frequently billed Medicare for kyphoplasty procedures on a more costly inpatient basis, rather than an outpatient basis, in order to increase their Medicare billings.

“This office will continue to ensure that sound medical decisions determine the ultimate treatment of a patient, not the financial interests of hospitals,” said U.S. Attorney William J. Hochul, Western District of New York. “We will not stand by and allow hospitals to inflate their profits based on unnecessary hospital admissions at the expense of the Medicare program or any other federal program. The settlements announced today will help maintain the integrity of this important program and all government-funded programs.”

The settling facilities, and the amounts they have agreed to pay, include the following:

Atrium Medical Center, Middletown, OH, has agreed to pay $4,232,992.50.

Altru Health System, Grand Forks, ND, has agreed to pay $1,492,690.

Cedars Sinai Medical Center, Los Angeles, CA, has agreed to pay $1,485,846.

Des Peres Hospital, St. Louis, MO, has agreed to pay $900,000.

MOUNT SINAI MEDICAL CENTER, Miami, FL, has agreed to pay $1,846,194.00.

New England Baptist Hospital, Boston, MA, has agreed to pay $374,814.48.

St. Anne’s Hospital, Fall River, MA, has agreed to pay $552,745.

The Queen’s Medical Center, Honolulu, HI, has agreed to pay $1,055,249.57.

Trover Health System, Madisonville, KY, has agreed to pay $1,162,837.

Wayne Memorial Hospital, Goldsboro, NC, has agreed to pay $1,250,000.

Twenty-three hospitals affiliated with HCA Inc., Nashville, TN, have agreed to pay a total of $7,145,842.72. These include:

Aventura Hospital & Medical Center (Aventura, FL); Capital Regional Medical Center (Tallahassee, FL); Coliseum Medical Center (Macon, GA); Coliseum Northside Hospital (Macon, GA); Conroe Regional Medical Center (Conroe, TX); Denton Regional Medical Center (Denton, TX); Doctors Hospital of Sarasota (Sarasota, FL); Edmond Regional Medical Center (Edmond, OK); Fawcett Memorial Hospital (Port Charlotte, FL); Fort Walton Beach Medical Center (Fort Walton Beach, FL); Garden Park Medical Center (Gulf Port, MS); JFK Medical Center (Atlantis, FL); Los Robles Regional Medical Center (Thousand Oaks, CA); North Florida Regional Medical Center (Gainesville, FL); Northlake Medical Center (Tucker, GA); Oklahoma University Medical Center (Oklahoma City, OK); Palmyra Medical Center (Albany, GA); Redmond Regional Medical Center (Rome, GA); Southwest Florida Regional Medical Center (Fort Myers, FL); St. Lucie Medical Center (Port Saint Lucie, FL); Summit Medical Center (Hermitage, TN); Sunrise Hospital & Medical Center (Las Vegas, NV); and Wesley Medical Center (Wichita, KS).

Six hospitals affiliated with Lifepoint Hospitals, Inc., Brentwood, TN, have agreed to pay a total of $2,522,502.69. These include:

Andalusia Regional Hospital (Andalusia, AL); Jackson Purchase Medical Center (Mayfield, KY); Lake Cumberland Regional Hospital (Somerset, KY); Minden Medical Center (Minden, LA); Russellville Hospital (Russellville, AL); and Western Plains Medical Complex (Dodge City, KS).

Five hospitals affiliated with Trinity Health, Livonia, MI, have agreed to pay…

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