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 catheterizations 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.