Health Law

Hospital to pay feds $40.9M for unnecessary heart surgeries; more than 500 patient suits are ongoing


A Kentucky hospital has agreed to pay the federal government a record $40.9 million to settle civil claims over what the government describes as unnecessary heart procedures billed to Medicare and Medicaid.

The settlement by King’s Daughters Medical Center announced Wednesday does not resolve more than 500 civil suits by former patients against the Ashland hospital and its coronary group, the Courier-Journal reports. They contend that patients suffered when doctors performed unnecessary procedures to boost profits.

A hospital spokesman didn’t immediately respond to a request for comment about Wednesday’s settlement, the Associated Press reports.

The news agency said the settlement is at least the fourth by a Kentucky hospital this year over false-billing claims and the largest ever in the Eastern District of Kentucky. A spokesman for the U.S. attorney’s office said this year’s settlements now total some $75 million. The $40.9 million settlement reportedly represents about double the money that the Ashland hospital received from the fraudulent billing.

In January, the London-based St. Joseph hospital operated by KentuckyOne Health agreed to pay the feds $16.5 million to resolve false-billing claims concerning heart procedures the government called unnecessary.

They included heart catheterizations, bypass graft surgeries, and the installation of pacemakers and stents, the Herald-Leader reported at that time. The hospital did not admit liability and said in a written statement that it had settled to avoid the cost of litigation. It also noted that the doctors at issue no longer work there.

“We are committed to providing the communities we serve with safe, high-quality health care performed with the highest of integrity,” said hospital president Greg Gerard in the statement.

A Courier-Journal article published early last year provides further noted that nearly 400 former patients brought civil cases against St. Joseph’s.

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