Serious Injuries Possible for Patients in Medicare Fraud Case

by | Jun 20, 2014 | Firm News, General Interest |

Here’s an interesting story about a hospital in Ashland, Kentucky,
just across the border from Ohio. The news describes a settlement in which
the hospital has agreed to pay back $40.9 million to the government, because
claims had been made that the hospital had falsely billed Medicaid and
Medicare. That’s not really the main problem though, since real
people had procedures they didn’t need. That could have left them
with serious personal injuries.

The lawsuit allegedly states that the King’s Daughters Medical Center
knew and deliberately ignored or recklessly disregarded the fact that
its cardiologists had inserted stents and completed characterizations
on patients who did not need those procedures. Therefore, the funds were
stolen not only from the taxpayers but also the very patients who could
have been harmed from these dangerous and unnecessary procedures.

The settlement for $40.9 million represents around twice as much money
as it received due to the alleged fraudulent billing. Kentucky, as a state,
will now receive over $1 million from the settlement, which will cover
the state’s share of Medicaid funds.

Not surprisingly, the settlement will not protect the hospital or doctors
from criminal charges that could be brought by patients. There is a potential
for around 520 lawsuits to be filed by former heart patients. The treatments
provided in the patients’ care was, quote, “motivated by financial
gain,” according to the U.S. Attorney for the Eastern District of Kentucky.

The man who represents the patients in private suits against the hospital
claims that this settlement may be the largest that has ever taken place
in the U.S. involving the use of unnecessary heart procedures. Independent
reviews have argued that the cardiac care at the hospital may meet or
exceed national standards.


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