Hospital Settles Medicare Dispute

A Harvard-affiliated hospital is one of seven nationwide that recently settled a U.S. Justice Department suit accusing the hospitals of violating Medicare billing procedures.

Beth Israel Deaconess settled for $3.2 million—the largest penalty of the seven hospitals—in an agreement finalized Thursday.

The lawsuit accuses the hospitals of unlawfully charging the government for medical procedures that used experimental cardiac devices that had not been proven safe and effective by the Food and Drug Administration.

Charging for such experimental procedures violates Medicare rules, said Charles S. Miller, a spokesperson from the Justice Department’s Civil Division.

“As far as we know, no one was injured using those devices, but that’s not the point. It’s that they’re not covered in Medicare provisions,” Miller said.

Beth Israel Deaconess spokesperson Jerry Berger said the suit did not “implicate” any hospital staff or professors.

“It was just a billing issue—how things were handled administratively,” he said.

The suit against the institutions originated through the False Claims Act, which allows a private citizen to bring suit on behalf of the U.S. government and share in any recovery the government wins.

A former medical device salesperson, Kevin Cosens, was the “whistleblower” who brought the case to the government’s attention, Miller said.

In total, the settlements now amount to more than $5.4 million, he said.

Berger said the settlement will not have any financial impact on the hospital.

“We knew the suit was pending and we had been planning for it for a while,” he said.

The Justice Department has also filed the same complaints against three other Massachusetts hospitals—Massachusetts Medical Center, Brigham and Women’s Hospital and Lahey Clinic.