8 Utah hospitals named in settlement for alleged Medicare violations

8 Utah hospitals named in settlement for alleged Medicare violations

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SALT LAKE CITY — Eight Utah hospitals were among the hundreds of medical facilities nationwide to reach a settlement with the federal government Friday for reportedly violating Medicare coverage requirements while providing implanted cardiac devices to patients.

In all, 457 hospitals coughed up $250 million for skirting Medicare coverage rules, the Department of Justice said, for treating patients by giving them an expensive implantable cardioverter defibrillator too soon after a heart attack or heart surgery.

"ICDs generally should not be implanted in patients who have recently suffered a heart attack or recently had heart bypass surgery or angioplasty," the Department of Justice said in a prepared statement Friday. "The medical purpose of a waiting period — 40 days for a heart attack and 90 days for bypass/angioplasty — is to give the heart an opportunity to improve function on its own to the point that an ICD may not be necessary."

Intermountain Medical Center, Utah Valley Regional Medical Center, Dixie Regional Medical Center's River Road campus and McKay-Dee Hospital — all member hospitals of the Salt Lake-based IHC Health Services Inc. — paid a combined $2 million in the settlement.

Fourteen facilities belonging to the Tennessee-based IASIS Healthcare Corp. — including Salt Lake Regional Medical Center, Jordan Valley Medical Center, Davis Hospital and Medical Center, and Pioneer Valley Hospital — paid out a total of $1.5 million.

Pioneer Valley Hospital changed its name last year to Jordan Valley Medical Center West Valley Campus.


In all, 457 hospitals coughed up $250 million for skirting Medicare coverage rules, the Department of Justice said, for treating patients by giving them an expensive implantable cardioverter defibrillator too soon after a heart attack or heart surgery.

The devices are implanted in a person's chest and detect and treat potentially fatal heart rhythms much like an external defibrillator would. The Department of Justice contends many patients across the country who didn't clinically qualify for the device were treated with it anyway from 2003 to 2010, leaving the hefty bill to Medicare.

The Department of Justice also defended health coverage for the device under Medicare, saying its availability to patients was appropriately "based on clinical trials and the guidance and testimony of cardiologists and other health care providers, professional cardiology societies, cardiac device manufacturers and patient advocates."

None of 457 investigated hospitals admitted wrongdoing as part of their settlement with the federal government Friday. Still, the Department of Justice characterized the settlement as a victory for whistleblowers and promised to continue investigating other hospitals for similar violations. In related settlements, informants reportedly received more than $38 million combined from most of the nationwide hospitals named as offenders Friday.

"The settlements announced today demonstrate the Department of Justice's commitment to protect Medicare dollars and federal health benefits. … Our office will continue to vigilantly protect the Medicare program from potential false billing claims," said Wifredo A. Ferrer, U.S. attorney for the Southern District of Florida, where the lawsuit was filed.

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