Washington, D.C. partner Jesse Witten was quoted in the media regarding recent False Claims Act settlements. The United States entered into settlements with 70 different health systems and hospitals, collectively worth $250 million as part of an investigation into the billing of Medicare for unnecessary implantable defibrillators.
Jesse, who represented four of the settling parties, said that the waiting periods prescribed by Medicare before implanting ICDs are a decade old and don’t keep up to the current best practices in medicine. Now, he says, hospitals will be more cautious before billing Medicare for ICDs for fear of being accused of fraud.
“When you see something like this that is industrywide and affects hundreds and hundreds of hospitals, is this really a crime wave or is there some underlying problem with the design of the government program?” said Jesse, speaking to Modern Healthcare. “It’s almost always the latter.”