Depuy Orthopaedics is questioning whether a surgical funding company is inflating damage claims from some of the 8,000 faulty hip replacements the medical device maker paid $2.5 billion to settle in 2013.
The company filed in federal court in Toledo, Ohio, Aug. 31 asking the court to compel surgical financer MedStar to turn over more information about liens it submitted to Depuy following the settlement, Reuters reported Monday. Texas-based MedStar submitted the liens seeking repayment for 11 revision surgeries it funded for ASR hip patients with claims against Depuy.
As part of the settlement, Depuy agreed to directly pay health insurers’ liens for replacement surgeries. MedStar submitted claims to Depuy for nearly $1.5 million for surgical bills it purchased on behalf of the 11 patients, though Depuy contends the surgeries shouldn’t have cost more than $336,000, Reuters says.
Patients who rely on medical funders are often those who are uninsured or unable to afford deductibles or out-of-network fees, the report notes. The funders purchase medical bills at a discount from care providers then earn a profit by placing a lien on the patient’s settlement for the full amount of the bill.
Depuy wants it investigated whether MedStar is seeking excessive profits by artificially inflating damage claims four times higher than what Depuy says it considers a reasonable cost, according to the report.
MedStar says its claims are reasonable, as determined by a medical pricing expert it retained who looked at the charges set by medical providers, company founder Dan Christensen told Reuters. If Depuy decides not to pay the liens, he said he will have “no other choice” but to demand payment from the patients themselves, which he said would be “extremely unfair,” according to the report.
Reuters reported in August that in pelvic mesh cases, another medical device subject to mass litigation, funders’ liens were sometimes 10 times higher than what private insurers or Medicaid would pay for such procedures. Several pelvic mesh manufacturers obtained records and deposition testimony on MedStar after learning a MedStar representative was soliciting physicians to perform mesh removal surgery, Reuters says.
(Story By The Times Union)
