tci Medicare Compliance & Reimbursement - 2010 Issue 20

Legal Strategies: Hospitals Involved in Kyphoplasty Investigations Have Viable Defenses

If this allegation can be proven, the government might not even have a false claims case. The American Hospital Association recently asked the federal government to review the appropriateness of its "kyphoplasty initiative," in which authorities are investigating hospitals that billed inpatient stays for Medicare patients who received the spinal procedure. In a September letter to the U.S. Attorney General and HHS Secretary, AHA notes that the kyphoplasty initiative originates from an FCA settlement involving a manufacturer of medical devices used in the surgical procedure to artificially restore collapsed vertebrae. The DOJ alleged in the investigations that...

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