ICD Settlements Raise Questions On Role Of NCDs As False-Claims Standard

Attorneys who work on False Claims allegations are pleased by the $250 million settlement on ICDs installed outside Medicare coverage policy, but electrophysiologists say the policy is out of date. But it's not clear that national coverage determinations will be a frequent source of false-claims suits in other device sectors.

A recent US Department of Justice settlement proved that the government can and will look to Medicare national coverage policies as a standard for pursuing allegations of false claims. What’s still unknown is whether DOJ might move to take similar action on possible false claims for other medical devices.

On Oct. 30, the US DOJ announced a settlement in which 457 hospitals in 43 states will pay more than...

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