Friday, April 20, 2018
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]

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