A former physician at the prestigious health system endangered patients when he unnecessarily replace batteries for implanted difibrillators.
New York-Presbyterian/Queens Hospital will pay more than $2.5 million after the prestigious health system self-reported that it billed Medicare for medically unnecessary replacements of batteries powering implanted defibrillators, the Department of Justice says.
According to federal regulators, a former physician -- who was not named in the DOJ’s media notice -- repeatedly replaced patients’ implantable cardioverter defibrillator batteries before they reached the elective replacement interval (ERI) that is determined by dedicated computer monitors.
“Such batteries were functioning normally. He therefore subjected his patients to unneeded and risky surgical procedures. New York-Presbyterian/Queens then submitted claims for payments to federal health care programs for these procedures,” DOJ says. “Physicians closely monitor the functioning of ICD batteries so that they replace the batteries when they are nearing the end of their lives, but no earlier. That way, physicians can balance the risks associated with a failing ICD battery against the risk of the procedure needed to replace that battery.”
When New York Presbyterian billed Medicare for the unneeded procedures it violated the False Claims Act, DOJ says.
After an internal investigation, New York-Presbyterian/Queens voluntarily self-disclosed the infractions to the Department of Health and Human Services, Office of Inspector General.
New York Presbyterian did not return HealthLeaders' request for comment. The health system was recently placed among the nation's Top 10 hospitals in 2022-23 by U.S. News & World Report.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
The doctor subjected his patients to avoidable health risks by performing the unneccesary procedures.
When New York Presbyterian billed Medicare for the unneeded procedures it violated the False Claims Act.
New York-Presbyterian/Queens self-disclosed the infractions to federal watchdogs.