Hospital agrees to $12 million settlement for alleged unnecessary cardiac procedures

South Miami Hospital agreed to pay the federal government approximately $12 million to settle allegations that it violated the False Claims Act by submitting false claims for medically unnecessary cardiac procedures performed by John R. Dylewski, MD.

The settlement was announced in a news release on Dec. 7. The U.S. Attorney’s Office in the Southern District of Florida mentioned the claims settled were allegations only, and they did not determine liability.

Amber Donner, Dylewski's attorney, told the South Florida Business Journal that Dylewski denies the allegations.

“South Miami Hospital cooperated fully with the United States government to reach a settlement in this case. The claims settled by the lawsuit are allegations only, and there has been no determination of liability,” Yvonne Johnson, MD, Chief Medical Officer at South Miami Hospital, told the South Florida Business Journal. “It is important for our patients to know that we are committed to providing the highest quality of care. Dr. John Dylewski is not practicing at our hospital.”

The allegations were brought forth in a whistleblower lawsuit that James A. Burks, MD and James D. Davenport, MD filed against South Miami Hospital.

Burks is a vascular surgeon who began his practice at South Miami Hospital in 2003, while Davenport is a cardiologist who served on peer review committees at South Miami Hospital between 2010 and 2014.

Burks and Davenport alleged that they knew Dylewski and South Miami Hospital engaged in unnecessary cardiac procedures to increase their reimbursement from Medicare and other federally-funded programs. They alleged that Dylewski performed unnecessary echocardiograms, electrophysiology studies, head upright tilt tests, and other treatments of arrhythmia by ablation, cryoablation or implantation of an electronic device, according to the news release.

Burks and Davenport will receive approximately $2,748,500 for bringing the allegations to light.

“Performing medically unnecessary heart procedures is shocking to the conscience,” Shimon R. Richmond, HHS-OIG Miami Special Agent in Charge, said in a news release. “Conducting cardiac catheterizations purely for profit, not patient care, seriously breaches the ‘do no harm’ commitment physicians pledge. Together with our law enforcement partners, we will seek out, stop these practices and protect the Medicare patients who are victimized by physicians participating in these schemes.”