Unnecessary stenting and other cardiac procedures have become a widespread problem, with cases arising in Texas, Tennessee, Maryland and Pennsylvania. Over the past few years, whistleblowers have exposed a number of fraudulent - and harmful - schemes by physicians, clinics, and hospitals based on performing unnecessary cardiac procedures, including angioplasties and stenting, in patients with coronary artery disease. Defendants in these cases falsely overstate the extent of the disease in patients' coronary arteries to justify performing expensive and invasive cardiac procedures, which are then billed to government healthcare programs.
In 2010, St. Joseph Hospital in Towson, Maryland agreed to settle allegations of medically unnecessary stenting procedures performed on hundreds of patients by Mark Midei, M.D. In 2011, the Department of Justice announced that it would intervene in a case brought against Jackson-Medicine County General Hospital and the Regional Hospital of Jackson (both in Tennessee), along with several physicians, for claims that they performed unnecessary diagnostic and therapeutic cardiac procedures on patients.
Most recently, the United States District Court for the Western District of Pennsylvania unsealed a qui tam case brought by whistleblower Tullio Emanuele, M.D., a former cardiologist with Hamot Medical Center (now UPMC Hamot) in Erie, Pennsylvania. The complaint (which names a number of cardiologists, their clinics, and UPMC Hamot as defendants) alleges that from at least 2001 to 2005, the defendants performed unnecessary diagnostic and interventional cardiac catheterization procedures and other vascular surgical procedures, and that they improperly billed or overbilled the government for services rendered. From April 2004 through February 2005, the cath lab activity records show that the defendant cardiologists performed 4,408 catheterizations on patients, which was double the number of catheterizations performed by other members of the group.
Moreover, the complaint alleges that UPMC Hamot paid illegal kickbacks to cardiologists and their practice groups in exchange for patient referrals. UPMC Hamot allegedly paid unlawful kickbacks by creating sham directorships, which paid $75,000 a year to cardiologists. In reality, however, these directorships were paid in order to induce cardiologists to refer patients to the hospital for costly cardiac procedures.
These profit-driven schemes involve procedures that unnecessarily place patients at significant risk of injury. Interventional cardiac procedures, such as angioplasties and stenting (which involve running a catheter into the arteries of the heart) place patients at risk of heart attack, stroke, blood vessel damage, and other complications.
False Claims Act lawsuits filed by whistleblowers bring to light schemes such as these, which pose serious risks to patient safety and defraud federal healthcare programs. These lawsuits also entitle whistleblowers to 15-25 percent of the government's civil monetary recovery. If you have information regarding unnecessary cardiac procedures performed by cardiologists, hospitals, or clinics, contact Andrew M. Beato, an experienced whistleblower attorney with the law firm of Stein, Mitchell & Muse, L.L.P. in Washington, D.C.
