Wednesday, December 13, 2017
Health

Morton Plant Mease hospitals pay $2.4 million to settle federal overbilling claims

CLEARWATER — Four Morton Plant Mease hospitals have agreed to pay the federal government more than $2 million to settle charges that they overbilled Medicare for a procedure used to treat spinal fractures often related to osteoporosis.

The hospitals in the nonprofit BayCare Health System were part of a $34 million settlement announced last week by the U.S. Department of Justice. It involved 55 hospitals nationally, including a dozen in Florida, concerning billing practices for a procedure called kyphoplasty.

In kyphoplasty, a physician uses a balloon and cement material to repair certain spinal fractures. The treatment can usually be done on an outpatient basis. But the hospitals had been billing Medicare for hospital admissions, netting higher payments.

The settlement covered patients treated between 2001 and 2010 at Morton Plant Hospital, Mease Dunedin Hospital, Mease Countryside and Morton Plant North Bay.

Federal officials highlighted the case as an example of their commitment to fighting health care fraud.

"We will not stand by and allow hospitals to inflate their profits based on unnecessary hospital admissions at the expense of the Medicare program or any other federal program," said William J. Hochul, U.S. Attorney for the Western District of New York, in a statement.

Morton Plant Mease officials admitted no wrongdoing in the settlement, stemming from a whistle-blower lawsuit filed by two former employees of the company that sold the materials needed to perform kyphoplasty.

Federal officials have now entered into similar deals with more than 100 hospitals charged with overbilling for kyphoplasty.

"We based our decisions on what we believed to be right for our patients, based on information that was available at the time," said Beth Hardy, a spokeswoman for the Morton Plant Mease system, stressing its commitment to complying with the latest federal regulations. "That can be a complex process."

The $2.4 million settlement is the second major false claims settlement in less than a year for BayCare. Last fall, six of its hospitals, including the Morton Plant Mease facilities, agreed to pay more than $10 million to settle allegations of overbilling for cardiac procedures for Medicare patients.

That case similarly focused on billing for hospital admissions that would have been less expensive as outpatients.

Times researcher Caryn Baird contributed to this article. Letitia Stein can be reached at [email protected]

Comments
An overlooked epidemic: Older Americans taking too many unneeded drugs

An overlooked epidemic: Older Americans taking too many unneeded drugs

Consider it America’s other prescription drug epidemic.For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 per...
Published: 12/13/17
How is Florida’s health? Not so great, report says

How is Florida’s health? Not so great, report says

Florida slightly improved its national standing this year, rising from 36th to 32nd overall in the annual America’s Health Rankings report. But the takeaway for the nation’s third-largest state is that it has a long way to go in many important health...
Published: 12/12/17
Driven by demand, Planned Parenthood opens second clinic in Tampa

Driven by demand, Planned Parenthood opens second clinic in Tampa

The floor-to-ceiling glass windows are heavily tinted and the inside is hidden behind rows of curtains. Security cameras monitor every corner, and only patients with an appointment and valid identification can pass through the intentionally cramped e...
Published: 12/12/17
Video: Jimmy Kimmel holds his baby son, post-heart surgery, in emotional health-care monologue

Video: Jimmy Kimmel holds his baby son, post-heart surgery, in emotional health-care monologue

Jimmy Kimmel was absent from his ABC late-night show last week while his 8-month-old son, Billy, recovered from his second heart surgery. Ever since Billy was born with a heart defect and required immediate surgery, Kimmel has become an outspoken adv...
Published: 12/12/17
Record numbers are signing up for Obamacare in Florida as enrollment period draws to a close

Record numbers are signing up for Obamacare in Florida as enrollment period draws to a close

With just four days left to enroll for health insurance on the federal exchange, advocates for the Affordable Care Act say Florida is headed for a record-breaking year. In week five of the six-week open enrollment period, about 823,180 people signed ...
Published: 12/12/17
A boy shares the pain of being bullied - inspiring thousands to show him love (w/video)

A boy shares the pain of being bullied - inspiring thousands to show him love (w/video)

While fighting back tears, young Keaton Jones couldn’t stop asking one question: Why?"Just out of curiosity, why do they bully? What’s the point of it?" he asks his mother while in the passenger seat of a parked car. "Why do you find joy in taking in...
Published: 12/10/17
Updated: 12/11/17
Legalization of marijuana for adults poses problems for people dealing with teens

Legalization of marijuana for adults poses problems for people dealing with teens

WESTMINSTER, Calif. — After Yarly Raygoza attended the drug prevention program at the Boys & Girls Club here last year, she used what she learned to talk a few friends out of using marijuana.The 14-year-old took the class again this year but worries ...
Published: 12/10/17
Millions gained coverage since Obamacare, but many are worse off as premiums soar

Millions gained coverage since Obamacare, but many are worse off as premiums soar

As open enrollment for Affordable Care Act coverage nears the deadline of Dec. 15, and Florida once again leads all states using the federal exchange at healthcare.gov, Heidi and Richard Reiter sit at the kitchen table at their Davie home and struggl...
Published: 12/10/17
A gift of hands: After loss, a man finds hope from healing ones (w/video)

A gift of hands: After loss, a man finds hope from healing ones (w/video)

ST. PETERSBURG — Francisco Piedra fixed his eyes on the man sitting beside him. His name was Richard Brown, and in his hands he held Piedra’s new ones.The prosthetics were black and plastic. Each one took about 20 hours to build from a 3D printer. Pi...
Published: 12/08/17
The solar eclipse burned a crescent wound on a woman’s retina. She wasn’t wearing proper glasses.

The solar eclipse burned a crescent wound on a woman’s retina. She wasn’t wearing proper glasses.

Like so many others, 26-year-old Nia Payne wanted to view of August’s historic solar eclipse but didn’t have a pair of protective glasses. She walked outside on Staten Island and glanced at the sun - 70 percent was covered - for about six seconds bef...
Published: 12/08/17