DOJ PUTS FINGER ON PULSE OF DEFIBRILLATOR IMPLANT SURGERIES
September 1, 2012
The federal government is concerned that many hospitals may have implanted defibrillator devices in patients without meeting applicable standards of care. As part of an effort to try to resolve investigations of the potential problem, the U.S. Department of Justice has asked hospitals in Portland and nationwide to conduct an assessment of whether such questionable surgical procedures were carried out on patients covered by Medicare. If there were, hospitals must assess whether they owe the government repayment and penalties for improper Medicare billing.
The implanted defibrillator devices are used to help regulate heart rhythms in patients whose unassisted heart functioning has become irregular. The devices themselves are extremely costly, being billed out at as much as $40,000 each. Some hospitals have carried out hundreds of implants of such devices on patients whose bills are paid by Medicare.
There are strict rules in place to govern when it is appropriate to use these devices on a patient with heart problems. The concern is that some hospitals may have performed the procedure and implanted the devices in patients whose situation does not fall within the guidelines. Not only does the unnecessary surgery put the patient at risk, but the request for payment from Medicare is questionable, if not out-and-out fraudulent under the False Claims Act.
In some instances, the government admits, there may have been medical reasons to deviate from the guidelines. The Justice Department is asking the hospitals to document all such exceptions.
The department also wants to know if any harm came to a patient as a result of the deviation from the standard of care, and whether an individual hospital was aware of a pattern of doctors carrying out inappropriate implant surgeries in their facilities. Knowledge of the practice could lead to increased penalties.
Source: Modern Healthcare, “Feds notify hospitals of liability for wrongly implanted heart devices,” Joe Carlson, Aug. 30, 2012
Our firm helps people who have been harmed by unnecessary surgery like the implant procedures discussed in this post. To learn more about our practice, please visit our Portland and Eugene, Oregon, medical negligence page.