Unnecessary back surgeries cost Medicare billions; UCHealth paying $23 million to resolve allegations of fraud; Amy Grant had open-heart surgery – Morning Medical Update

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Unnecessary back surgeries costing Medicare up to $600 million annually

Over 200,000 back surgeries were performed unnecessarily in the United States over the course of three years, according to a new Lown Institute report. In sum, these low-value back procedures cost Medicare about $2 billion after three years, roughly $600 million annually.

“We trust that our doctors make decisions based on the best available evidence, but that’s not always the case,” Vikas Saini, MD, president of the Lown Institute, said in an organizational release. “In spinal surgery, as with other fields of medicine, physicians routinely overlook evidence to make exceptions, sometimes at shockingly high rates. This type of waste in Medicare is costly, both in terms of spending, and in risk to patients.”

UCHealth will pay $23 million to resolve allegations of fraudulent billing for emergency department visits

University of Colorado Health (UCHealth) is alleged to have violated the False Claims Act, seeking and receiving payment from federal health care programs by submitting evaluation and management (E&M) claims to the Medicare and TRICARE programs for visits to its emergency departments. UCHealth has agreed to pay $23 million to resolve these allegations.

“Improperly billing federal health care programs drains valuable government resources needed to provide medical care to millions of Americans,” Brian M. Boynton, principal deputy assistant attorney general, head of the Justice Department’s Civil Division, said in a news release. “We will pursue health care providers that defraud the taxpayers by knowingly submitting inflated or unsupported claims."

Musician Amy Grant shares personal experience with cardiovascular disease

Grammy Award-winning singer-songwriter, Amy Grant, underwent open-heart surgery to correct a rare condition affecting her heart. Inspired by her surprising diagnosis, Grant now works to support the mission of the American Heart Association (AHA), helping to raise awareness about cardiovascular disease (CVD), which his currently the top cause of death for women. “The risk to women is often overlooked, yet the numbers tell a story we cannot ignore,” Grant said in a news release. “I’m honored to share my story and ask for people to come together, give generously to the [AHA] and make heart health a priority.” Read the full AHA news release here.