The American Heart Assn. lauded the U.S. Justice Dept.'s efforts to provide guidelines for hospitals to resolve a large-scale investigation into potential heart implant fraud, but warns that certain rules may prevent doctors from doing what's right for patients.
The U.S. Dept. of Justice offered hospitals nationwide a guide to responding to a federal investigation into heart implants and Medicare billing, but the American Heart Assn. warned that some of the agency's guidelines may end up hurting patients.
The DoJ issued an ICD investigation resolution model through which hospitals can determine whether an implanted cardiac defibrillator meets Medicare criteria and can thus be excluded from the investigation.
It appears to be a new approach for the DoJ and the Centers for Medicare & Medicaid Services in dealing with potential Medicare fraud, but the one-size-fits-all guidelines may target some justified implants and chill physicians' judgment in making calls that are best for their patients, the AHA warned.