published: Sunday, February 12, 2012

Florida Hospital part of Medicare fraud settlement

By ED BALDRIDGE

ed.baldridge@newssun.com

SEBRING -- Florida Hospital Heartland is one of four Adventist Health System care facilities that will pay a total of $3.9 million in a Medicare fraud settlement, according to a press release from the U.S. Department of Justice on Thursday.

Florida Hospital of Orlando, Florida Hospital Fish Memorial, Florida Hospital-Oceanside along with the Sebring Florida Hospital are part of the Altamonte Springs Adventist Health System.

The U.S. Government alleged that the organization submitted false claims to Medicare between 2000 and 2008.

Florida Hospital was cited for claims related to a procedure called kyphopasty, the treatment for a spine fracture attributed to osteoporosis and prevalent in older women.

"This settlement is being handled by the Adventist Health Systems Corporate and no one is available for comment at this time," said Cathy Albritton, director of marketing and public relations for Florida Hospital Heartland Division on Saturday.

The DOJ claimed a less invasive and less expensive procedure could have been performed in many of the cases.

The DOJ settled with 14 hospitals in total for a total of $12 million, of which the Central Florida hospitals have to pay about a third.

According to an article in the Orlando Sentinel on Thursday, Gulf Coast Hospital, Lee Memorial Hospital, both of Fort Myers and Cape Coral Hospital also settled for lesser amounts.

Additionally, hospitals in New York, Mississippi, North Carolina, Washington, Indiana and Missouri were involved in the settlement, the Sentinel article stated.

"Patients want reassurance that their health care provider is making treatment decisions based on the patient's best interests, not an interest in maximizing profits," said Tony West, assistant attorney general for the Justice Department's Civil Division was quoted in the Sentinel. "By recovering taxpayer dollars lost to improper billing, this settlement will help support the vital public health care programs we depend on."

All of the care facilities were part of a whistleblower suit filed by two individuals who worked for a spinal surgery equipment company.

Those individuals will receive $2 million from the settlements, according to the DOJ, under the False Claims Acts. The False Claims Act also allows private citizens to share in the proceeds by bringing suits against facilities on behalf of the U.S. Government.