Craig Patrick and Charles Bates — former employees of spinal medical equipment giant Kyphon — blew the whistle on Rex Healthcare for improperly billing Medicare for out-patient surgeries as in-patient procedures. Raleigh, N.C. based Rex Healthcare will pay $1.9 million, plus interest, to settle allegations that it submitted false claims for such minimally-invasive procedures as Kyphoplasty. (To see an animation of a kyphoplasty procedure, click here.) According to DoJ, Rex Healthcare “routinely submitted claims to Medicare for a variety of minimally-invasive procedures during the period 2004 through 2007, which the hospital classified as inpatient admissions in order to increase its reimbursement from Medicare, despite the absence of medical necessity justifying the more expensive inpatient admissions.” FraudBlawg has previously reported similar qui tam settlements here and here.
To report Medicare fraud, contact Frohsin & Barger.