CINCINNATI - Atrium Medical Center in Middletown is one of 55 hospitals named in a Justice Department settlement of allegations that they submitted false claims to Medicare for kyphoplasty procedures.
The settlement did not include a finding of liability.
Kyphoplasty is a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In most cases, the surgery can be safely performed on an outpatient basis. But hospitals allegedly submitted bills as inpatient procedures to yield a higher payment.
The allegations came from a Whistleblower lawsuit filed by former employees of Kyphon Inc., a provider of equipment and services needed for the spinal surgery. Kyphon's corporate successor, Medtronic, signed a $75 million settlement in the same case in May.
A Justice Department press release announced the latest settlement Wednesday. It names Atrium as the hospital facility that will pay the largest amount: Just over $4.2 million. The 55 hospitals named in the release will pay a combined $34 million. The Justice Department said it has now settled billing disputes over kyphoplasty with more than 100 hospitals.
"Hospitals that participate in the Medicare program must bill for their services accurately and honestly," said Stuart F. Delery, Acting Assistant Attorney General for the Civil Division of the Department of Justice. "The Department of Justice is committed to ensuring that Medicare funds are expended appropriately, based on the medical needs of patients rather than the desire of medical providers to maximize profits."
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