Jackson hospital pays $1.3 million to resolve improper billing claims

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JACKSON, Tenn. — Jackson-Madison County General Hospital has paid $1.3 million to the U.S. government to resolve allegations of billing Medicare and Medicaid for unnecessary cardiac treatments, according to a release from the U.S. Department of Justice. The treatments involved the placement of unnecessary cardiac stents and other unnecessary cardiac procedures, the release states. The release states the settlement with the hospital resolves claims that it billed Medicare and Medicaid for unnecessary procedures performed from January 2004 through December 2011. Cardiac stents are mesh tubes placed in coronary arteries to keep the arteries open to treat coronary heart disease, according to the release. The other procedures include angioplasty, catheterization and ultrasound imaging, the release states. Under federal law, Medicare and Medicaid only reimburse hospitals for procedures that are medically necessary. “Billing Medicare for cardiac procedures that are not necessary or appropriate contributes to the soaring costs of health care and harms patients,” Edward L. Stanton III, U.S. Attorney for the Western District of Tennessee, states in the release. “Settlements like this protect public funds and safeguard the beneficiaries of federal health care programs.”

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