Federal Medicare settlement costs Altru $1.5 millionAltru Health System paid $1.5 million as part of a $34 million settlement that it and 54 other hospitals reached with the federal government over allegations that they used more expensive inpatient procedures rather than outpatient spinal surgeries to get bigger Medicare payments, the U.S. Justice Department said Tuesday.
By: Christopher Bjorke, Associated Press
Altru Health System paid $1.5 million as part of a $34 million settlement that it and 54 other hospitals reached with the federal government over allegations that they used more expensive inpatient procedures rather than outpatient spinal surgeries to get bigger Medicare payments, the U.S. Justice Department said Tuesday.
The settlement involves kyphoplasty procedures used to treat spinal fractures usually caused by osteoporosis. It can be done as an outpatient procedure, but the Justice Department said the hospitals performed the surgeries as inpatient procedures to increase Medicare billings.
“We strongly disagree with the government’s position on this,” said Altru Chief Financial Officer Dwight Thompson.
He said Altru followed care recommendations from North Dakota and national care improvement organizations.
“We thought we were following all the rules,” he said. “Hospitals across the board follow those guidelines.”
Altru agreed to the settlement last August and the payment was included in its 2012 budget, according to Thompson. It has been in litigation with the government over the procedures since 2010, and the system settled to avoid further legal expenses.
“It went on and on along with many hospitals throughout the country,” he said. “We do not admit to any wrongdoing.”
He said the settlement covered procedures at Altru going to back to 2008, but he did not know how many were part of the government’s action. Altru will continue to treat some of the kyphoplasties with inpatient hospital stays, but will bill them to Medicare as outpatient procedures.
“Hospitals that participate in the Medicare program must bill for their services accurately and honestly,” Stuart F. Delery, acting Assistant Attorney General for the civil division of the Justice Department, said in a statement.
A similar settlement was reached last year, when 14 hospitals agreed to pay a settlement of more than $12 million. And in 2008, the Justice Department agreed to a $75 million settlement with Medtronic Inc.’s spine business. The government was investigating allegations that Kyphon, a company that had been acquired by Medtronic Spine in 2007, advised hospitals to do inpatient kyphoplasties to bulk up their Medicare payments.
In the latest settlement, other hospitals with the large payments are Atrium Medical Center of Middletown, Ohio, which will pay $4.2 million; Mount Sinai Medical Center in Miami, $1.8 million; Cedars Sinai Medical Center in Los Angeles, $1.5 million; Wayne Memorial Hospital in Goldsboro, N.C., $1.3 million; Trover Health System of Madisonville, Ky., $1.2 million; The Queen’s Medical Center in Honolulu, $1.1 million.
No other hospitals in North Dakota, South Dakota or Minnesota were involved in the settlement.
More on the Web: http://1.usa.gov/1b53CX2">1.usa.gov/1b53CX2
Call Bjorke at (701) 780-1117; (800) 477-6572, ext. 1117; or send e-mail to firstname.lastname@example.org. The AP contributed to this report.