Mission Hospital reaches agreement in lawsuit, will pay $1.5 million

Today, Mission Hospital announced it has reached an agreement with the U.S. Department of Justice in regard to allegations made that the hospital performed a certain spinal procedure on an inpatient basis instead of an outpatient basis. Mission has agreed to pay $1.5 million. The press release is as follows:

From the press release:

ASHEVILLE, N.C., Feb. 7, 2011 – Mission Hospital announced it has reached an agreement with the U.S. Department of Justice to settle allegations that it improperly performed certain medical procedures on an inpatient basis, versus an outpatient basis.

The Justice Department has been looking into whether hospitals nationwide overcharged Medicare by performing a minimally invasive spinal procedure known as kyphoplasty on inpatient basis. There is disagreement as to whether the procedure should be performed on an inpatient or outpatient basis. Mission has agreed to pay $1.5 million in settlement.

“There was no intent to defraud Medicare, nor were any procedures done unnecessarily,” said Ronald A. Paulus, M.D., president and CEO of Mission Health. “Our physicians exercised their best judgment and determined that the procedure was most appropriately performed in our hospital. However, the Department of Justice decided there was insufficient documentation in our patient records to support such determination. We have updated our procedures, so that going forward we will have the requisite information to support our decisions.”

More than two dozen hospitals have reached similar settlements with the government (including other hospitals in North and South Carolina), as well as Kyphon, the company that developed and marketed the procedure.

About Mission Health
Mission Health, based in Asheville, NC, is the state’s sixth largest health system and the tertiary care regional referral center for Western NC and the adjoining region. In 2012, Mission Health was named by Thomson Reuters as one of the top 15 health systems in the nation – the only health system in North Carolina to receive this recognition.
Founded in 1885, Mission Health is a not-for-profit, independent community hospital system that operates four hospitals, numerous out-patient and surgery centers, and the region’s only dedicated Level II trauma center. Its medical staff consists of more than 750 physicians, and is certified in over 50 medical specialties and sub-specialties. Centers of excellence include heart, stroke care and neurosciences, and pediatrics. Mission Hospital, the system’s flagship hospital, is licensed for 730 beds and is the busiest surgical hospital in North Carolina. Other Mission hospitals include Blue Ridge Regional Hospital in Spruce Pine, McDowell Hospital in Marion, and Mission Children’s Hospital in Asheville.

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