Hospitals Settle Federal Allegations Of ICDs Implanted Afoul Of Medicare Policy
This article was originally published in The Gray Sheet
Executive Summary
More than 400 hospitals settled with the Justice Department following a five-plus year investigation into ICD implants performed during post-heart attack and post-surgery periods when Medicare policy states the devices generally should not be put in.
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The Department of Justice says the additional 51 hospitals that settled with the government on charges of billing for ICD implants outside of Medicare coverage guidelines represent the "final stage" of a long-running investigation. DoJ previously identified another 457 hospitals that have settled. Hospitals payments tied to the investigation total $273 million.
ICD Settlements Raise Questions On Role Of NCDs As False-Claims Standard
Attorneys who work on False Claims allegations are pleased by the $250 million settlement on ICDs installed outside Medicare coverage policy, but electrophysiologists say the policy is out of date. But it's not clear that national coverage determinations will be a frequent source of false-claims suits in other device sectors.
Ruing Registries: Emotions Run High Among EPs In Wake Of JAMA ICD Study
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