N.C. Hospital to Pay $1.9 Million Over Kyphoplasty, Medicare Claims

RALEIGH, N.C.—A Raleigh-based hospital has agreed to pay $1.9 million, plus interest, to resolve allegations it submitted false claims to Medicare for minimally invasive procedures, the U.S. Department of Justice announced April 4.

According to federal prosecutors, Rex Healthcare routinely classified the minimally invasive procedures—which included kyphoplasty, a spinal fracture treatment—as inpatient admissions despite a lack of medical necessity. The charges involve Medicare billing from 2001 through 2007.

The allegations and settlement stemmed from a whistleblower lawsuit originally filed in 2005 with the U.S. District Court for the Western District of New York (U.S. ex rel. Bates v. Kyphon ...