457 hospitals settle over false-claim violations on cardiac devices

In Georgia, more than 450 hospitals are being required to pay more than $250 million to settle accusations that in some instances cardiac devices, which violate the program’s coverage requirements, were implanted in Medicare patients.

According to Savannah Now, Atlanta’s Department of Justice announced that the Atlanta hospitals involved in the settlement include Emory University Hospital, Saint Joseph’s Hospital.

The cardiac device in question is an implantable cardioverter defibrillator, or ICD. The ICD is an electronic device which is typically implanted near and connected to the hearts of patients who might potentially suffer heart complications.

The device works to detect life-threatening heart rhythms, called fibrillations. When fibrillations are detected, a shock is delivered to the heart restoring it to its normal rhythm.

A National Coverage Determination governs the Medicare coverage for the device, which costs around $25,000. This governing body has concluded that an ICD should not be implanted in a patient who has recently suffered a heart attack, or has recently had a heart bypass surgery or angioplasty.

A waiting period is generally adhered to, which allows professionals a chance to more accurately determine whether or not an ICD is required.

The Department of Justice has alleged that between 2003 and 2010, a number of Georgia hospitals implanted ICDs during the waiting period, which is prohibited by the National Coverage Determination.

Federal officials have issued a statement saying that the claims resolved by the settlements are allegations only. They claim that there has been no determination of liability at this time.

Additionally, the settlement amounts vary. For example, the Emory University Hospital has cooperated fully since the initial investigations in 2010.

“Emory completed a voluntary review of about 230 ICD claims and its policies and procedures, and worked with the government under its resolution model to reach a settlement of $2.4 million,” the hospital said in a statement on Friday.

The settlement amount of other hospitals vary from $1.6 million to $7.2 million.

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