Two Cleveland hospitals accused of mischarging Medicare

By MALIA RULON, Associated Press Writer
WASHINGTON (AP) - The federal government joined lawsuits against two Cleveland hospitals on Tuesday, saying they improperly charged Medicare millions of dollars for experimental cardiac devices.
The Cleveland Clinic and University Hospitals of Cleveland are accused of falsely billing the federal health care program for devices such as pacemakers and implanted defibrillators from 1990 to 1995.
At the time, the Food and Drug Administration considered the devices experimental, so they were not reimbursable by Medicare.
Most of the devices since have been approved, and Justice Department spokesman Richard Miller said there are no allegations that the equipment harmed anyone.
The Cleveland Clinic said in a statement that the lawsuit seeks to punish the hospital for providing Medicare patients with the best and most advanced cardiac care. Hospital officials said the lawsuit is without merit.
"Congress realized that Medicare's non-coverage policy was unfair to Medicare patients and overturned it in 1995. As a result, the government now pays for the very same devices that it alleges in this lawsuit it should not have paid for a decade ago," the hospital said.
A message seeking comment on the suit was left for University Hospitals.
The lawsuits, filed in U.S. District Court, came from a whistleblower complaint filed in 1994 by Kevin Cosens, a former medical device salesman. Cosens sued the hospitals under the False Claims Act, which lets private citizens bring lawsuits on behalf of the government and get a share of awards.
As part of his job, Cosens visited hospitals around the country and became familiar with the experimental uses of heart defibrillators, arterial guide wires and tools heart specialists used to remove plaque from clogged coronary arteries, according to Miller.
About 38 similar lawsuits have been filed against hospitals across the country. Federal prosecutors have reached settlements with 34 of the cases for a total of about $45 million, the Justice Department said.
(Copyright 2003 by The Associated Press. All Rights Reserved.)