A $4.4 million settlement has been reached in a whistleblower lawsuit involving medically unnecessary heart procedures at an Elyria, Ohio hospital, EMH Regional Health Care center.  The hospital and a doctor practice group, North Ohio Heart Center, were accused of performing unnecessary angioplasties and billing Medicare for them.  The hospital will pay $3.9 million; the doctors' group will pay $541,870. The whistleblower, Kenny Loughner, the former manager of the hospital's catherization lab, will receive $660,859 of the settlement. 

Source:  New York Times

Patients at the hospital were receiving angioplasties at four times the national average as discussed in a 2006 New York Times article,  Heart Procedure Is Off the Charts In An Ohio City.

This whistleblower suit was brought under the federal False Claims Act. Its essence was that the hospital and doctors group defrauded Medicare by certifying as medically necessary and being paid for the heart procedures that were not necessary.  

Be the first to comment!
Post a Comment