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A Kentucky hospital has settled a claim by the federal government that it billed Medicare and Medicaid for unnecessary heart surgeries, agreeing to pay nearly $41 million. The King’s Daughters Medical Center, in Ashland, had been accused in a federal government lawsuit of intentional or reckless disregard for the truth for performing a large number of procedures for patients who did not need them, including the insertion of stents and catheterization of patients.
The hospital was the subject of an investigation by the Louisville division of the FBI, which concluded that the hospital had engaged in a lengthy pattern of routinely billing government health insurance programs for procedures that patients did not need. The U.S. Attorney’s office in Lexington, which prosecuted the case, said that the amount of the settlement represented approximately double the amount that the hospital had taken in as a result of the fraudulent acts.
The settlement reach with King’s Daughters Medical Center only addresses the hospital’s liability for civil fraud upon the government. It does not preclude hospital officials from facing criminal charges for their acts, nor does it prohibit any of the patients who were subjected to unnecessary surgery from filing personal injury lawsuits. Sources say that more than 500 lawsuits have already been filed by former patients.
The settlement is the second such agreement with a Kentucky hospital this year. KentuckyOne Health’s St. Joseph hospital settled a similar claim by the federal government in January, based on an investigation that found it had performed unnecessary heart surgeries and fraudulently billed Medicaid and Medicare.
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