November 28, 2017

California-based Cardiovascular Consultants Heart Center and its shareholder physicians — Dr. Kevin Boran, Dr. Michael Gen, Dr. Rohit Sundrani, Dr. Donald Gregory, and Dr. William Hanks — agreed to pay $1.2 million to settle allegations of violating the False Claims Act by billing Medicare and Medicaid for medically unnecessary cardiovascular diagnostic procedures.  According to the government, company physicians automatically scheduled patients for nuclear stress tests on an annual basis without seeing the patients beforehand to confirm the procedure was necessary.  These test are expensive and expose patients to a significant amount of radiation as well as to the risk of invasive procedures based on false positive results.  This risk is only justified if the nuclear stress test is medically necessary.  DOJ (EDCA)

Tagged in: FCA Federal, Lack of Medical Necessity, Provider Fraud,