Cardiology practices pay $17.7M to settle fraud allegations brought on by whistleblowers
A total of sixteen cardiology practices from 12 different states have agreed to pay more than $17.7 million to resolve allegations they overbilled Medicare for diagnostic radiopharmaceuticals.
According to a statement from the U.S. Department of Justice (DOJ), these practices were accused of reporting “inflated acquisition costs” to Medicare for radiopharmaceuticals needed to perform medical imaging examinations and diagnose certain cardiovascular conditions. Practices included in the announced settlement allegedly participated in this scheme for up to 10 years. Whistleblowers helped make the DOJ aware of the alleged scheme; these individuals will receive approximately $2.7 million from these settlements for supporting the investigation.
“Practices and providers who overcharge the government and fail to return overpayments compromise our healthcare programs,” U.S. Attorney Matthew M. Graves for the District of Columbia said in a DOJ statement. “When people see the wrong and report it, we have the tool we need to put a stop to this type of irresponsible conduct. So, I applaud the whistleblowers who came forward in this case.”
“These practitioners overbilled the Medicare program by grossly exaggerating the acquisition costs of drugs used in diagnostic imaging of the heart,” added U.S. Attorney Michael A. Bennett for the Western District of Kentucky. “This office is committed to protecting our federal health care programs, and we will hold accountable anyone who seeks to exploit them.”
These are the practices involved and the amounts that each one must pay:
- Western Kentucky Heart & Lung Associates PSC and Mohammed Kazimuddin ($6,750,000)
- Heart Clinic of Paris P.A. and Arjumand Hashmi ($2,600,000)
- Scranton Cardiovascular Physician Services LLC ($2,369,111)
- Shannon Clinic ($996,856)
- Edward W. Leahey M.D. Professional Association and Edward Leahey ($894,679)
- Metropolitan Cardiovascular Consultants LLC and Ayim Djamson ($846,888)
- Cardiology Center of New Jersey LLC, Mario Criscito, Frank Iacovone, and Sameer Kaul ($740,000)
- Clovis Cardiology Associates LLC and Mahamadu Fuseini ($600,000)
- Family Medical Specialty Clinic PLLC, Melecio Abordo, and June Abadilla ($409,594)
- James R. Higgins M.D. Inc. and James Higgins ($395,537)
- TrustCare Health LLC ($279,407)
- Taj Medical Inc. ($240,000)
- White River Diagnostic Clinic PLC, Margaret Kuykendall, and Seth Barnes ($234,490)
- Veinguard Heart & Vascular Center P.C. and Fareeha Khan ($195,000)
- Boulder Medical Center PC ($160,000)
- Wellspring Cardiac Care P.A. ($50,000).
This settlement does not technically represent an admission of guilt by these clinicians or their practices; there was no determination of liability, and these resolved claims are still only allegations.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.