Bayhealth hospitals in Delaware will pay more $1 million to settle claims that they overcharged Medicare for a back procedure known as “kyphoplasty.”
The settlements resulted from the federal government’s ongoing investigation into billing for kyphoplasty procedures by hospitals nationwide.
Earlier, Christiana Care, the state’s largest health care provider agreed to a $3 million settlement in a similar case.
It was alleged that Kyphon, which sold the equipment and materials used to perform the procedure, persuaded hospitals to submit false claims to Medicare and other government health care programs by showing how much greater their revenues would be by billing kyphoplasty as an inpatient, rather than an outpatient, procedure. Inpatient care generally isn’t medically necessary for routine, scheduled kyphoplasty procedures. Kyphoplasty is used to treat certain spinal compression fractures often due to osteoporosis.
A balloon device pumps up the compressed vertebra, and then bone cement is injected into the cavity after the balloon is removed. The Bayhealth hospitals in Delaware Kent General Hospital, Dover and Bayhealth Milford Memorial Hospital, Milford. The total settlement was $1.1 million.
