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An Ocala, Florida, cardiologist, Dr. Asad Qamar, and his practice, the Institute of Cardiovascular Excellence, will pay $2 million, plus release any claim to $5.3 million in suspended Medicare funds, to resolve a lawsuit alleging that they improperly billed Medicare, Medicaid and TRICARE for medically unnecessary procedures, federal officials announced Thursday.<\/p>\n
They also paid kickbacks to patients by waiving Medicare copayments irrespective of financial hardship.<\/p>\n
Dr. Qamar also agreed to a three-year period of exclusion from participating in any federal health care program. \u00a0The settlement relates to two consolidated lawsuits in which the United States intervened on Dec. 22, 2014, officials said.<\/p>\n
\u201cBilling federal health programs for medically unnecessary procedures is unacceptable \u2013 not only does it waste taxpayer funds, but it also puts patients at risk,\u201d said Principal Deputy Assistant Attorney General, Benjamin C. Mizer, head of the Justice Department\u2019s Civil Division. \u00a0\u201cToday\u2019s settlement evidences the Department of Justice\u2019s firm commitment to protect public funds and to safeguard the well-being of federal health care program beneficiaries.\u201d<\/p>\n
The settlement resolves the government\u2019s lawsuit claiming that Dr. Qamar and ICE billed Medicare, Medicaid and TRICARE for excessive, medically unnecessary and inadequately documented peripheral artery interventional services and related procedures, according to officials.<\/p>\n
Many of the cardiovascular procedures for which Dr. Qamar and ICE billed Medicare and the other programs were not indicated by patients\u2019 medical histories or records, or the severity of the patients\u2019 symptoms.<\/p>\n
The government also alleged that to help facilitate this false billing scheme, Dr. Qamar and ICE routinely and indiscriminately waived the 20 percent Medicare copayment, irrespective of the patient\u2019s financial need.<\/p>\n
Medicare copayments assure that patients have an incentive to be smart healthcare consumers and avoid unnecessary procedures.<\/p>\n
By waiving the required copayments indiscriminately, Dr. Qamar and ICE induced patients to agree to unnecessary and invasive procedures and other services.<\/p>\n
Officials said Dr. Qamar\u2019s and ICE\u2019s illegal conduct made Dr. Qamar the highest paid Medicare cardiologist in the country in 2012 and 2013.<\/p>\n
\u201cPatient safety is of paramount importance,\u201d said U.S. Attorney A. Lee Bentley III for the Middle District of Florida.\u00a0 \u201cWhen a doctor performs medically unnecessary and invasive procedures on Medicare patients, federal healthcare programs are defrauded and, more importantly, patients\u2019 lives and wellbeing are recklessly put at risk.\u00a0\u00a0This case shows our office\u2019s steadfast commitment to holding medical providers personally responsible for their actions.\u201d<\/p>\n
\u201cWhen\u00a0medical professionals act on greed to perform unnecessary, invasive procedures on Medicare and Medicaid patients, both patient health and taxpayer funds are compromised,\u201d said Special Agent in Charge Shimon R. Richmond of HHS-OIG. \u00a0\u201cOur agents and investigators will continue to work hard with our law enforcement partners to ensure that health care providers who engage in such illegal behavior are held accountable.\u201d<\/p>\n
The allegations resolved by today\u2019s settlement were originally raised in two lawsuits filed pursuant to the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government when they discover evidence that defendants have submitted false claims for government funds and to receive a share of any recovery.<\/p>\n
The False Claims Act also permits the government to intervene in such lawsuits, as it has done in these cases.<\/p>\n
The plaintiffs who filed the whistleblower lawsuits, Dr. Robert A. Green and Ms. Holly A. Taylor, will receive $1.3 million as their share of the settlement, according to officials.<\/p>\n
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An Ocala, Florida, cardiologist, Dr. Asad Qamar, and his practice, the Institute of Cardiovascular Excellence, will pay $2 million, plus release any claim to $5.3 million in suspended Medicare funds, to resolve a lawsuit alleging that they improperly billed Medicare, Medicaid and TRICARE for medically unnecessary procedures, federal officials announced Thursday.<\/p>\n","protected":false},"author":1,"featured_media":24889,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,3],"tags":[2813,2812,1616],"class_list":["post-24885","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-home-main-slider","category-u-s-department-of-justice","tag-cardilogist","tag-institute-of-cardiovascular-excellence","tag-whistleblower"],"yoast_head":"\n