Arizona Heart Hospital Allegedly Billed Medicare For Non-Covered Procedures
WASHINGTON – LAWFUEL – The Legal Newswire – Arizona Heart Hospital in Phoenix and two groups of doctors associated with the health care facility have agreed to pay the United States $6,720,412 to settle allegations that they improperly billed Medicare for non-covered procedures in which artificial graft devices were used to treat patients with aortic aneurysms, the Justice Department announced today.
Some of the procedures were not covered for reimbursement by Medicare because they involved devices that were considered experimental by Medicare at the time the procedures were performed. In other cases, the procedures did not comply with approved protocols for devices that were in clinical trials. The government’s allegations in this case related solely to whether the procedures at issue were properly reimbursable by Medicare; quality of patient care was not at issue in this case.
Arizona Heart Hospital has agreed to pay $5,820,412 in one settlement. Two other entities, Arizona Heart Institute and AHI Cardiovascular Surgeons Ltd., have paid the remaining $900,000.
“Limited Medicare dollars should not be spent on procedures that remain experimental,” said Peter D. Keisler, Acting Attorney General and Assistant Attorney General for the Department’s Civil Division. “We will continue to be vigilant to keep providers from attempting to circumvent the requirements of federal law.”
The case was handled by the Justice Department’s Civil Division, the U.S. Attorneys’ Office in Phoenix, the Food and Drug Administration, and the Office of Inspector General of the Department of Health and Human Services.