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Settlement Over Alleged False Medicare Claims Reached

ELYRIA, Ohio — A multi-million dollar settlement is reached between the federal government and a local hospital and physicians group.  Federal prosecutors say they submitted false claims to Medicare.

EMH Medical Center in Elyria has agreed to pay the United States government $3,863,857 to settle allegations that they submitted false claims to Medicare.  North Ohio Heart Center, an independent physicians group that operates at the hospital, has agreed to a settlement of $541,870.

“What we discovered was that certain patients would come in and they would be examined and there were unnecessary cardiac procedures that were performed on them,” said Steven Dettelbach, United States Attorney for the Northern District of Ohio.

According to federal prosecutors, doctors performed angioplasty and stent procedures on heart disease patients whose conditions were not severe enough to require the procedures.

“Obviously the first it risks patient health, but in addition, it risks fiscal heath.  In our country our Medicare programs now are under a lot of stress and we can’t afford as a country to be paying money for procedures that shouldn’t have been performed in the first place,” Dettelbach said.

“The physicians that provided the care to these patients firmly believe at the the time of the care that it was the most appropriate treatment for the patient at that time,” said Dr. Donald Sheldon, President and CEO of EMH Healthcare.

He says doctors have different views on how to treat heart patients, but felt a settlement was the best way to move forward.

“Medical treatment is a very complex issue and the physician needs to take many facets of the patient’s situation into account when making a treatment decision,” Sheldon said.

Dr. John Schaeffer, chairman and president of North Ohio Heart Center released a statement, reading in part: “The settlement is not an admission of wrongdoing, rather, we settled this matter so we can put it behind us and move forward … We felt confident we were making correct choices for our patients … We still do.”

“If today’s settlement says anything, it sends a message that patient health and taxpayer health have to come before profit and greed,” said Dettelbach.

The person who blew the whistle in the case, the former manager of EMH’s catheterization and electrophysiology lab, receives $660,859 as part of the settlement.

Sheldon tells Fox 8 that while employed at the hospital, the man never brought up any concerns.