55 Hospitals to Settle Alleged Kyphoplasty False Claims for $34M

Molly Gamble -  

Across 21 states, 55 hospitals have agreed to pay more than $34 million total to resolve alleged false claims to Medicare for kyphoplasty procedures.

Kyphoplasty is a minimally invasive procedure used to treat certain spinal fractures, which are often due to osteoporosis. In many cases, the procedure can be performed effectively and safely in the outpatient setting, which is less costly than an inpatient procedure.


The hospitals are resolving allegations that they frequently billed Medicare for kyphoplasties on an inpatient basis to boost their Medicare reimbursements. The Department of Justice has now reached settlements with more than 100 hospitals totaling approximately $75 million to resolve allegations they mischarged Medicare for kyphoplasty procedures.  


Below is a listing of the latest settlements, beginning with the largest monetary amount. A complete listing of individual hospitals under each system settlement can be found here.


• Twenty-three hospitals affiliated with Nashville, Tenn.-based Hospital Corp. of America — $7.15 million


• Atrium Medical Center (Middletown, Ohio) — $4.23 million


• Five hospitals affiliated with Livonia, Mich.-based Trinity Health — $3.91 million


• Four hospitals affiliated with Clearwater, Fla.-based Morton Plant Mease BayCare Health System — $2.38 million


• Six hospitals affiliated with Brentwood, Tenn.-based LifePoint Hospitals —  $2.52 million


• Two hospitals affiliated with Knoxville, Tenn.-based Covenant Health — $1.85 million


• Mount Sinai Medical Center (Miami Beach, Fla.) —$1.85 million


• Altru Health System (Grand Forks, N.D.) — $1.49 million


• Cedars-Sinai Medical Center (Los Angeles) —$1.49 million


• Wayne Memorial Hospital (Goldsboro, N.C.) — $1.25 million


• Trover Health System (Madisonville, Ky.) — $1.16 million


• Two hospitals affiliated with Newark, Del.-based Bayhealth Medical Center — $1.12 million


• The Queen's Medical Center (Honolulu) —$1.06 million


• Des Peres Hospital (St. Louis) — $900,000


• Three hospitals affiliated with Memphis, Tenn.-based Baptist Memorial Health Care — $691,168


• St. Anne's Hospital (Fall River, Mass.) — $552,745


• New England Baptist Hospital (Boston) —$374,814


More Articles on Legal Issues:
OIG Releases Updated Provider Self-Disclosure Protocol
HIPAA Compliance: 5 Key Considerations for ASCs, Physician Practices and Small Providers
12 of the Largest False Claims Settlements in 2012

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

Featured Webinars

Featured Whitepapers

Featured Podcast