The Justice Department said Friday that it had reached settlements totaling more than $250 million with hundreds of hospitals where doctors implanted cardiac devices in violation of Medicare coverage requirements.
The settlements encompass nearly 500 hospitals in 43 states where cardioverter defibrillators were implanted in Medicare patients too soon after they suffered a heart attack, had heart bypass surgery or angioplasty.
Medicare sets waiting periods of up to 90 days before implanting the $25,000 devices, which deliver mild electric shocks to restore a normal heart rhythm. Clinical trials have shown the heart often recovers its own rhythm during that time, making the pricey defibrillators unnecessary.
"The settlements announced today demonstrate the Department of Justice's commitment to protect Medicare dollars and federal health benefits," said Wifredo A. Ferrer, U.S. Attorney for the Southern District of Florida.
"Guided by a panel of leading cardiologists and the review of thousands of patients' charts, the extensive investigation behind the settlements was heavily influenced by evidence-based medicine."
A 2011 study led by researchers at Duke University of 111,707 patients that received cardioverter defibrillators found that nearly a quarter received no clinical benefit. Those patients were also shown to develop significantly more post-procedural complications, including death.
The settlements, said to be among the largest of their kind, are the result of a federal whistleblower lawsuit filed in Florida 7 years ago by cardiac nurse Leatrice Ford Richards and Thomas Schuhmann, a health care reimbursement consultant.
Under the False Claims Act, the whistleblowers will reap about $38 million from the settlements. A portion of that will go to Bryan Vroon, their Atlanta-based attorney.
Among the large health-care providers involved, Hospital Corporation of America, headquartered in Nashville, Tennessee, agreed to pay $15.8 million. Ascension Health, of St. Louis, Missouri, settled for $14.9 million.
The Justice Department lists all of the companies and hospitals involved in the settlement in this document. It includes dozens of Florida hospitals.
Adventist Health System Sunbelt Healthcare Corporation, based in Altamonte Springs, Florida, and the following 11 affiliated hospitals paid a total of $5.5 million:
· Adventist Bolingbrook Hospital
· Adventist Hinsdale Hospital
· Adventist La Grange Memorial Hospital
· Florida Hospital Flagler
· Florida Hospital Oceanside
· Florida Hospital Orlando
· Florida Hospital Waterman
· Florida Hospital Zephyrhills
· Huguley Memorial Medical Center
· Metroplex Hospital
· Shawnee Mission Medical Center
Health Management Associates, Inc., based in Franklin, Tennessee, and the following 27 affiliated hospitals paid a total of $7.2 million:
· Bartow Regional Medical Center
· Biloxi Regional Medical Center
· Central Mississippi Medical Center
· Charlotte Regional Medical Center
· Dallas Regional Medical Center
· Davis Regional Medical Center
· East Georgia Regional Medical Center
· Harton Regional Medical Center
· Heart of Florida Regional Medical Center
· Highlands Regional Medical Center
· Lancaster Regional Medical Center
· Lehigh Regional Medical Center
· Lower Keys Medical Center
· The Medical Center of Mesquite
· Medical Center of Southeastern Oklahoma
· Midwest Regional Medical Center
· Northwest Mississippi Regional Medical Center
· Peace River Regional Medical Center
· Physicians Regional-Pine Ridge
· Poplar Bluff Regional Medical Center-North Campus
· Riley Hospital
· Riverview Regional Medical Center
· Sebastian River Medical Center
· Sparks Regional Medical Center
· Stringfellow Memorial Hospital
· Venice Regional Medical Center
· Yakima Regional Medical and Cardiac Center
IASIS Healthcare Corporation, based in Franklin, Tennessee, and the following 14 affiliated hospitals paid a total of $1.5 million:
· Davis Hospital and Medical Center
· Glenwood Regional Medical Center
· Jordan Valley Medical Center
· The Medical Center of Southeast Texas
· Memorial Hospital of Tampa
· Mesa General Hospital
· Mountain Vista Medical Center
· North Vista Hospital
· Odessa Regional Medical Center-East Campus
· Odessa Regional Medical Center-West Campus
· Pioneer Valley Hospital
· Saint Luke’s Medical Center
· Salt Lake Regional Medical Center
· Southwest General Hospital
Tenet Healthcare, based in Dallas, Texas, and the following 19 affiliated hospitals paid a total of $12.1
million:
· Baptist Medical Center
· Brookwood Medical Center
· Creighton University Medical Center-Saint Joseph Hospital
· Delray Medical Center
· Des Peres Hospital
· Doctors Medical Center of Modesto
· Frye Regional Medical Center
· Hahnemann University Hospital
· Harper University Hospital
· Houston NW Medical Center
· MacNeal Hospital
· North Shore Regional Medical Center-FMC Campus/Florida Medical Center
· Palm Beach Gardens Medical Center
· Palmetto General Hospital
· Saint Francis Hospital
· Saint Louis University Hospital
· Saint Vincent Hospital
· Sierra Medical Center
· Sinai-Grace Hospital
Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital, located in Tampa, Florida, paid $2 million.
The Justice Department says it continues to investigate additional hospitals.