Hospitals Performing Unneccessary Procedures to Boost Profits

Hospitals Performing Unneccessary Procedures to Boost Profits | Pintas & Mullins Law Firm

Invasive and unnecessary heart procedures are being performed around the country, according to a recent article by theNew York Times. Unfortunately, these procedures are motivated by profit rather than patient safety. Our Chicago medical malpractice lawyers recognize the dangers of this disturbing trend, and are dedicated to helping unnecessary surgery victims obtain the compensation they deserve.

The article takes a close and critical look at HCA, the largest hospital chain in the United States, where more than a thousand unnecessary heart treatments have been performed. The dangers are widespread, because HCA has facilities in at least 20 states around the country, including California, Florida, and Texas.

Details about the shocking procedures being performed at one of the company’s Florida hospital were recently revealed through a combination of confidential memos, emails, and interviews with doctors. A 2010 review shows that as many as half of all cardiac catheterizations were performed on patients without significant heart disease. Internal documents indicate that doctors inflated medical reports to falsely suggest that the procedures were necessary.

Financial motivations are likely to blame in this case, and in many other instances of Medicare fraud. When unnecessary procedures are performed on patients, hospitals prosper. Testing and performing heart surgeries translate into big business for hospitals. In fact, Medicare reimburses hospitals about $10,000 for every cardiac stent that doctors implant in a patient. The law requires that hospitals notify Medicare or Medicaid if the procedure was unnecessary in order to prevent fraud, however there is no evidence that HCA met its legal duty of disclosure.

Sadly, while the payoff may be huge for hospitals, patients and taxpayers both suffer when unnecessary procedures are performed. All invasive heart procedures carry a risk of serious complications, including infection and nerve damage. When alternative measures are available and even preferable, doctors should use reasonable medical judgment to protect the interests of patients. These procedures also drive up healthcare costs and raise insurance premiums.

This is not the first time HCA has been accused of illegitimately collecting money from the Medicare program. In 2002, the hospital chain paid out about $1.7 billion in fines and repayments to settle one of the largest cases of Medicare fraud in U.S. history. The settlement was based on allegations of overbilling that eventually resulted in removing Rick Scott from the hospital’s board of directors.

Defrauding the government to collect Medicare reimbursements seems to be a problem that reaches far beyond HCA hospitals. The non-profit group Pro-Publica estimates that only half of all non-emergency heart catheterizations are appropriate. The group also points out that studies show blood thinking medication lone is just as effective, if not more so, for patients suffering from heart disease. 

Medicare fraud is something that the U.S. government takes seriously. The Office of Inspector General for the U.S Department of Health and Human Services is tasked with protecting Medicare and Medicaid programs and their beneficiaries. A Medicare fraud conviction results in severe penalties that include prison time and hefty fines. Employees that report Medicare fraud are protected from retaliatory termination and are eligible to collect up to 30 percent of the fines.

An experienced medical malpractice attorney can also help patients collect compensation if they have been harmed by unnecessary hospital procedures. Stents that are needlessly implanted in patients can lead to serious health complications, and in some cases, even death. Patients who are already suffering from heart problems should not be forced to undergo unnecessary and even dangerous procedures that could harm them even more.