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Medicare Reimbursement

Charlotte, NC: (Nov-05-07) The US Department of Justice (DOJ) brought charges against Arizona Heart Hospital, one of the 11 hospitals in which MedCath owns an interest, alleging that the facility violated the federal Civil False Claims Act. The suit primarily dealt with the question of whether certain medical procedures, such as services involving the implantation of certain endoluminal graft devices which are utilized to treat aneurysms, though not approved by the Food and Drug Administration, were properly reimbursable by Medicare. The suit stated that such procedures were either implanted without an approved investigational device exception (IDE) or were implanted outside of the approved IDE protocol.

As part of a settlement reached, the hospital denied engagement in any wrongdoing or illegal conduct, and the settlement agreement does not contain any admission of liability. Further, as per MedCath's filing with the US Securities and Exchange Commission, the hospital will pay approximately $5.8 million to settle and obtain a release from any civil or administrative monetary claims related to the DOJ's investigation. The hospital has additionally entered into a five-year corporate integrity agreement with the Office of the Inspector General of the Department of Health and Human Services, under which it will continue to maintain its existing corporate compliance program related to clinical trials conducted at the hospital. [CNN NEWS: MEDICARE REIMBURSEMENT]

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Published on Nov-6-07


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