UPDATE 3-Hospitals to pay $250 mln for cardiac device coverage violations -DOJ

viernes 30 de octubre de 2015 17:26 GYT

(Adds comments from Catholic Health Initiatives, paragraphs 10-11)

By Suzanne Barlyn

Oct 30 (Reuters) - Hundreds of U.S. hospitals will pay a total of more than $250 million stemming from allegations that they implanted cardiac devices in Medicare patients in violation of coverage requirements, the U.S. Justice Department said on Friday.

The 457 hospitals are from 43 states, the Justice Department said.

The settlement involves a type of device that detects and treats extremely fast, life-threatening heart rhythms, called fibrillations, by delivering a shock to the heart, the Justice Department said.

But only patients with certain medical characteristics and risk factors qualify for the device, known as an implantable cardioverter defibrillator, or ICD, the Justice Department said.

Medicare guidelines provide that doctors should not implant ICDs in patients who have recently suffered a heart attack or had other procedures, such as heart bypass surgery. Each of the hospitals that settled on Friday had implanted ICDs during 40 day waiting periods that Medicaid requires for heart attack patients and 90 day waiting periods for bypass patients.

The conduct occurred between 2003 and 2010.

Hospitals hit with the largest fines include Ascension Health in St. Louis, Missouri ($14.9 million), Catholic Health East in Newtown Square Pennsylvania, now part of Trinity Health Corp ($11 million), and Catholic Health Initiatives in Englewood Colorado ($7.8 million).   Continuación...