The latest settlement elevates the total amount recovered to $101 million collected from 25 hospitals around the country as well as the former Kyphon Inc.
The US Department of Justice announced the latest settlement early in the New Year.
The qui tam lawsuit was originally brought by two former employees of Kyphon Inc., which is now known as Medtronic Spine LLC. The allegation is that kyphoplasty, a type of back surgery that in most cases can be safely performed as an outpatient procedure, was costing Medicaid (and hence the federal government) millions of dollars extra after hospitals routinely kept patients overnight.
Attorneys representing the government whistleblowers alleged that retaining kyphoplasty patients overnight was self-serving and benefited the hospitals financially, but carried no benefit for the patient. In most cases, according to the Justice Department release, a typical kyphoplasty patient is up and walking within a few hours of the procedure.
It was noted that Kyphon sold equipment and materials used to perform the procedures to hospitals and advised the institutions on billing practices for kyphoplasty. Lawyers for the federal whistleblowers noted that costs associated with outpatient care are much lower than the financial impact to Medicare of keeping a patient in hospital overnight.
Seven hospitals located in Alabama, Florida, Mississippi, North Carolina, South Carolina and Texas, bring to 25 the number of hospitals involved in the alleged defrauding of Medicare in this case.
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Even at the lowest level of 15 percent split two ways, the two men will net millions each and will join other government whistleblowers in the lineup at the bank…