Modern advances in the medical field allow individuals to live longer and more fulfilling lives. Many conditions that were previously considered a death sentence can now be treated with a variety of medical devices and surgical procedures. In recent years, however, there has been some concern that hospitals and doctors are performing procedures that may not be medically necessary. The U.S. Justice Department is currently conducting a widespread investigation into several possible cases of hospital negligence.
The investigation stems from reports that Medicare patients at several hospitals around the country received heart defibrillators that were not medically necessary. In an effort to root out potential negligent cases, the Justice Department has requested that hospitals around the country and in states including Ohio perform an audit of patients who received heart defibrillators.
Used to prevent complications in patients with irregular heartbeats, the cost of an implantable defibrillator runs about $40,000 per unit. This makes defibrillators one of the most expensive medical devices for which hospitals can bill Medicare. The issue, government officials say, is that some hospitals seemed to perform an unusually high number of procedures to implant the devices.
There are strict guidelines that dictate the medical conditions that would necessitate the implantation of a heart defibrillator. Hospitals are being asked to evaluate each case against those guidelines and determine how many procedures failed to meet these guidelines.
In response to the investigation, many doctors have argued that the Medicare guidelines dictating when a defibrillator is appropriate are outdated. Under the provisions of the False Claims Act, Patients who are found to have received defibrillators that were not medically necessary can sue for damages up to three times the actual amount.
Source: Modern Health Care, "Feds notify hospitals of liability for wrongly implanted heart devices," Joe Carlson, Aug. 30, 2012