Ashland hospital to pay $40.9 million in fraud settlement

ASHLAND, Ky. (WKYT)- King's Daughters Medical Center in Ashland has agreed to pay the U.S. Government $40.9 million to settle allegations of fraudulent billing.

The hospital was accused of making millions of dollars by falsely billing federal health care programs for heart procedures that
were performed on patients who didn't medically need them.

"The conduct alleged in this matter is unacceptable, victimizing both taxpayers and patients," said U.S. Attorney for the Eastern District of Kentucky Kerry B. Harvey. "Treatment decisions motivated by financial gain undermine public confidence in our health care system and threaten vital federal programs upon which so many of our citizens rely."

The government claimed between 2006 and 2011, KDMC maximized
reimbursements from Medicare and Kentucky Medicaid by billing for numerous unnecessary coronary stents and diagnostic catheterizations. The government also alleged that the physicians falsified medical records in order to justify the unnecessary procedures.

Kerry Harvey says he believes this case marks the largest settlement involving a hospital in the history of the Eastern District of Kentucky.

The settlement amount roughly doubles the amount of money
KDMC received as a result of the alleged fraudulent billing for the unnecessary services.

The Commonwealth of Kentucky will receive $1,018,380 which for the
state's share of the recovered Medicaid funds. The Medicaid program is funded jointly by the federal and state governments.

"We take very seriously our obligation to ensure the safety of patients in Kentucky and to hold accountable those who put profits ahead of patient care," said Kentucky Attorney General Jack Conway.

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