American Elephants


Nearly 500 Hospitals Have Misbehaved, Or Have They? by The Elephant's Child

hospHospitals in 43 states will pay a combined $250 million in fines to settle charges that they violated Medicare requirements when implanting cardiac devices in patients.

The heavy hand of government descended on 457 hospitals accused of implanting cardioverter defibrillators in patients between 2003 and 2010 before Medicare coverage allowed. It seems that Medicare will cover the devices, which cost around $25,000, but only if doctors wait the recommended 40 days after a patient has had a heart attack and 90 days after a patient has had bypass surgery to do the implant. The waiting periods are designed by some bureaucrat to “give the heart an opportunity to improve function on its own to the point that the defibrillator may not be necessary.”

The DOJ said most of the hospitals were named in a lawsuit brought on by whistleblowers under the False Claims Act, which allows private citizens to bring lawsuits on behalf of the United States and receive a portion of the proceeds of any settlement or judgment awarded against a defendant.

The lawsuits were filed by a cardiac nurse and a health care reimbursement consultant in the U.S. District Court for the Southern District of Florida. The DOJ said the whistleblowers received more than $38 million from the settlements.

This may be all on the up and up. Over-cautious doctors disobeying the ordered 40 day wait time and costing Medicare money. The doctors motives for squandering Medicare money? The whistleblowers motives to go for $38 million? Did all or any of the patients survive? Don’t know.

Where are the whistleblowers who get big rewards from stopping, say, the EPA from wasting taxpayer money? With 457 different hospitals, the whistleblowers had no chance to observe incorrect wait times. Perhaps the doctor’s judgement is different?  I make no accusations. I just find it all odd, and sadly, I trust Doctors much more than I trust Medicare bureaucrats.

 


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