Nearly 500 hospitals covering 43 states will reimburse $257 million to Medicare patients who were part of improper cardiac implant surgeries. Heart attack patients were implanted with cardioverter defibrillators a little too early following their incidents. The patients had to undergo angioplasty or heart bypass surgery.
The Justice Department announced on Oct. 30 the settlement for the violation of federal rules. The $257 million settlement will be given through Medicare payments. A waiting period of up to 90 days has been set by Medicare before the $25,000-worth cardioverter defibrillator can be used. Clinical trials have proven that a human heart can recover its natural rhythm within the waiting period, which makes the cardioverter defibrillators an unnecessary expense.
In a 2011 study conducted by Duke University researchers, the findings showed that almost 25 percent of the 111,707 patients who got cardioverter defibrillators following their heart attacks showed no medical benefit from the devices. Researchers also found that patients encountered more post-surgery problems, one of which is death.
The $257 million settlement is the biggest of its kind to date and a triumph feat of the lawsuit filed by whistleblowers Leatrice Ford Richards and Thomas Schuhmann in Florida seven years ago. Richards is a cardiac nurse while Schuhmann is a consultant for health care reimbursement. The two are entitled to approximately $38 million from the $257 million under the False Claims Act. The Atlanta-based lawyer Bryan Vroon is representing the two whistleblowers.
"The settlements announced today demonstrate the Department of Justice's commitment to protect Medicare dollars and federal health benefits. 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," said U.S. Attorney for the Southern District of Florida Wifredo A. Ferrer.
Hospitals with the largest fines include Colorado-based Catholic Health Initiatives ($7.8 million), Missouri-based Ascension Health ($14.9 million), Pennsylvania-based Catholic Health East ($11 million), which now belongs in the Trinity Health Corporation family, and Tennessee-based Hospital Corporation of America ($15.8 million).
The Justice Department published (PDF) a list of the hospitals involved in the case and are still investing for additional hospitals that need to be penalized.
Photo: Phalinn Ooi | Flickr