Cardiologist and his practice do the DOJ Kickback Suit
The DOJ is settling the case with the Beaumont doctor who allegedly billed tests that never took place.
Cardiologist Dinesh Shah, MD, paid the government $ 2 million to pay for the fees he billed federal health programs for diagnostic tests, which are usually ankle brute force index and toe brute force – Indexes, both of which measure blood flow from the heart to the extremities. to receive kickback fees. The prosecution also focused on unnecessary nuclear stress tests. According to the Department of Justice (DOJ), these tests were never actually conducted.
Prosecutors said that Shah and his practice, Michigan Physicians Group, billed Medicare, Medicaid, and Tricare tests from 2006 to 2017, “regardless of whether they were medically necessary” in order to receive kickback incentives.
“It will not be tolerated to subject patients to unnecessary tests in order to fill their pockets with taxpayers’ money,” said acting US attorney Saima Mohsin. “Such practices are of particular concern because overuse of some tests can be harmful to patients.”
Photo by Oles kanebckuu from Pexels
The settlement is part of a 2018 resolution in which William Beaumont Hospital, Royal Oak, paid $ 84.5 million to clarify allegations that it had inappropriate relationships with eight referring doctors. These actions resulted in false claims being filed with Medicare, Medicaid, and Tricare from 2004 to 2012.
“Offering financial incentives to doctors in exchange for patient referrals undermines the integrity of our healthcare system,” said Acting Assistant Attorney General Chad A. Readler of the DOJ’s Civil Division at the time. “Patients deserve the unreserved, independent judgment of their health care professionals.”
“Health care providers who offer or accept financial incentives in exchange for patient referrals undermine both the financial integrity of federal health programs and public trust in medical facilities,” said the Special Agent of the Inspector General of Health and Social Services (HHS-OIG) in charge of Lamont Pugh. “Our agency will continue to protect both patients and taxpayers by holding those who engage in fraudulent backlash systems accountable.”
The Anti-Kickback Act prohibits offering, paying, soliciting, or receiving compensation to initiate referrals for items or services covered by Medicare, Medicaid, and other programs.
Prosecutors said Beaumont offered these doctors well above-market compensation to secure patient referrals and allegedly provided free or low-cost office space. Eventually, four whistleblower lawsuits were filed. In total, more than 21 doctors were named.
The lead whistleblower is a noted neuroscientist, Dr. David Felten, who claimed he had been ignored for years. From 2005 to 2013 he was Medical Director for the William Beaumont Hospital Research Institute. At that point he had to resign. There Felten observed firsthand and reported on many of the compensation agreements that were under the table.
“My results raise a deeply worrying question,” said Felten. “If someone demonstrates a lack of integrity in their financial operations, why should I believe they are demonstrating integrity in clinical practice or research?”
Beaumont has entered into a five-year corporate integrity contract with HHS-OIG to regulate the kickback system and regulate liability under the False Claims Act. Shah and his practice have also entered into an Integrity Agreement with HHS-OIG that will monitor the company’s billing practices for a period of three years. However, the DOJ determined that there was no liability statement and no admission of misconduct.
The cardiologist coughs $ 2 million for unnecessary procedures
The Detroit Area Hospital System is paying $ 84.5 million to resolve allegations of false claims resulting from improper payments to referring doctors