“More than 450 US hospitals agreed to pay over 250 million dollars for ICD implantation violations
More than 450 hospitals in 43 states have agreed to pay more than $250 million to settle claims they placed implantable cardioverter defibrillators (ICDs) in Medicare patients who did not meet coverage requirements, according to an announcement from the US Department of Justice.
The settlement stems from allegations that hospitals violated the Centers for Medicare and Medicaid Services (CMS)National Coverage Determination (NCD) by failing to observe a waiting before implanting the ICD in patients who recently had an MI or underwent coronary revascularization. The 40-day post-MI and 90-day post-CABG/angioplasty waiting periods are intended to allow sufficient time for cardiac recovery following the clinical event and/or procedure, allowing physicians to determine whether an ICD is truly needed.
The Department of Justice alleged that between 2003 and 2010, physicians from 457 US hospitals implanted ICDs in patients without adhering to the 40-day and 90-day waiting periods, thereby violating the Medicare NCD.”