Orlando Cardiologist Pays $ 6.75 Million to Resolve Claims of Unnecessary Medical Procedures | Takeover bid

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Dr Ashish Pal, a cardiologist based in Orlando, Florida, paid $ 6.75 million to resolve allegations that he violated the False Claims Act by performing medically unnecessary ablations and venous stent procedures.

The settlement resolves allegations that, from January 1, 2013 to December 31, 2019, Dr. Pal knowingly submitted false statements to federal health care programs for medically unnecessary ablations and venous stent procedures. The government alleged that Dr Pal performed the ablations and stenting procedures on veins that did not qualify for treatment to accepted standards of medical practice. Additionally, the government alleged that Dr Pal made false statements in patients’ medical records to justify the procedures, including exaggerating the degree of reflux and the diameter of the veins, and falsely documenting the patient’s symptoms. The United States has also alleged that in many cases ablations were performed either exclusively or primarily by one or more ultrasound technicians outside of their scope of practice.

Doctors are only supposed to perform procedures when they have a legitimate medical basis for doing so, said Acting Deputy Attorney General Brian M. Boynton for the Civil Division of the Department of Justice. The ministry will prosecute those who waste taxpayer dollars and subject patients to unwarranted medical treatment.

Our office is committed to protecting vulnerable patients from those who put financial gain before the needs of patients, said Interim U.S. Attorney Karin Hoppmann of the Middle District of Florida. We will continue to hold accountable those who abuse nations’ health programs at the expense of taxpayers.

When doctors enrich themselves by performing medically unnecessary procedures on Medicare and Medicaid beneficiaries, they threaten the health of their patients and embezzle taxpayer funds intended to pay for needed care, Special Agent in Charge Omar said. Prez Aybar of the US Department of Health and Human Services Office of the Inspector General (HHS -BIG). We will continue to work hard with our law enforcement partners to ensure that healthcare providers who engage in such abusive behavior are held accountable.

Healthcare providers within the military healthcare system are committed to patient satisfaction and take seriously their obligation to ensure excellent outcomes by providing the highest quality care, said the director general of the Army Ronald J. Place, MD of the Defense Health Agency (DHA). We are grateful to the United States Department of Justice for working to maintain this trust by ensuring that healthcare providers continue to put the needs and safety of their patients first.

The Office of Inspector General’s Office of Personnel Management (OPM-OIG) is dedicated to investigating providers who prioritize benefits over patient welfare, said the deputy inspector general serving as Inspector General Norbert E. Vint for the OPM-OIG. We will continue to work with our law enforcement partners and our colleagues in the Department of Justice to protect federal health care programs from fraud.

To help ensure that the alleged abuse described in this case does not recur, Dr. Pal and Interventional Cardiology & Vascular Consultants, PLC have entered into a detailed, multi-year integrity agreement with the HHS-OIG. This Integrity Agreement contains training and reporting requirements as well as a quarterly review of claims by an independent review body, with the requirement that the review team include at least one certified interventional cardiologist. by the board of directors. It also contains provisions regarding stipulated penalties and possibly exclusion from federal health programs such as Medicare and Medicaid for breach of its terms.

The resolution obtained in this case is the result of a coordinated effort between the Civil Divisions Commercial Litigation Branch, the Fraud Section and the US Attorneys Office for the Middle District of Florida, with the assistance of the Department of Defense Office of Inspector General. , the FBI, the Office of the Inspector General of the US Department of Health and Human Services and the Office of Personnel Management of the Office of the Inspector General.

The government’s pursuit of this issue illustrates its focus on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Advice and complaints from all sources regarding potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800HHSTIPS (800-447-8477).

This case was handled by Nicholas C. Perros of the Civil Divisions Commercial Litigation Branch, Fraud Section, and United States Assistant Attorney Michael R. Kenneth of the United States Attorney’s Office for the Central District of Florida.

The claims resolved by the settlement are only allegations, and there has been no determination of liability.

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