St. Joseph Hospital in London will pay $16.5 million to the federal government to settle charges that it got money from Medicare and the federal-state Medicaid program for unnecessary heart procedures, according to a document released Tuesday. The schemes and subsequent fines the hospital now faces may cause even more financial problems for KentuckyOne Health, Andrew Wolfson writes for The Courier-Journal.
Almost 400 former patients filed lawsuits, claiming cardiologists at the hospital performed "unnecessary, risky and often painful heart procedures to unjustly enrich themselves," Wolfson reports. According to the claims, two patients died and some will have to take blood-thinning medications for the rest of their lives, leaving them vulnerable to possibly fatal complications.
Several doctors at the hospital conducted unnecessary, invasive procedures such as heart stents and catheterizations on Medicare and Medicaid patients between 2008 and 2011, the government claimed; hospitals usually get $10,000 to $15,000 for each procedure, Wolfson notes.
"We all rely on health care providers to make treatment decisions based on clinical, not financial considerations," U.S. Attorney Kerry Harvey said in a news release. "The conduct alleged in this case violates that fundamental trust and squanders scarce public resources set aside for legitimate health care needs."
According to Harvey's office, the investigation continues because various doctors were involved, and their crimes are not absolved through the fine, Bill Estep reports for the Lexington Herald-Leader. For example, Dr. Sandesh R. Patil "pleaded guilty last year to lying about the severity of a patient's condition to make sure the government would pay for heart procedures," Estep reports. "Patil was sentenced to 30 months in prison."
Although St. Joseph London agreed to pay the $16.5 million, it did not admit violating the law, a common provison in such cases.. The hospital said it agreed to pay the penalty to avoid further expenses, "'uncertainty of prolonged litigation, and to allow the hospital to move forward.' It said the allegations arose in 'past relationships with some cardiologists who no longer practice at the hospital'," Wolfson reports.
St. Joseph President Greg Gerard said, "We are committed to providing the communities we serve with safe, high quality health care performed with the highest of integrity."
Three Central Baptist Hospital cardiologists in Lexington—Drs. Michael R. Jones, Paul W. Hollingsworth and Michael Rukavina—played a key role in discovering St. Joseph-London's malpractice, Estep reports. When they noticed that some patients they treated had been subjected to unnecessary procedures at London, they sued in 2011. "One patient who came to the Lexington practice had undergone 17 heart catheterizations—performed mostly by Patil—in London in four years, none of them necessary, according to the report," Estep writes. The three cardiologists will get $2,458,810 of the $16.5 million settlement, according to Harvey's office.
Although St. Joseph-London is finished with the civil portion of the case, the federal government will continue trying to get money from the doctors and clinics identified in the lawsuit, Harvey said. "This result would not be possible without the commitment of private citizens exposing this type of egregious fraud," said Perry K. Turner, special agent in charge of the FBI in Kentucky.
Almost 400 former patients filed lawsuits, claiming cardiologists at the hospital performed "unnecessary, risky and often painful heart procedures to unjustly enrich themselves," Wolfson reports. According to the claims, two patients died and some will have to take blood-thinning medications for the rest of their lives, leaving them vulnerable to possibly fatal complications.
Several doctors at the hospital conducted unnecessary, invasive procedures such as heart stents and catheterizations on Medicare and Medicaid patients between 2008 and 2011, the government claimed; hospitals usually get $10,000 to $15,000 for each procedure, Wolfson notes.
"We all rely on health care providers to make treatment decisions based on clinical, not financial considerations," U.S. Attorney Kerry Harvey said in a news release. "The conduct alleged in this case violates that fundamental trust and squanders scarce public resources set aside for legitimate health care needs."
According to Harvey's office, the investigation continues because various doctors were involved, and their crimes are not absolved through the fine, Bill Estep reports for the Lexington Herald-Leader. For example, Dr. Sandesh R. Patil "pleaded guilty last year to lying about the severity of a patient's condition to make sure the government would pay for heart procedures," Estep reports. "Patil was sentenced to 30 months in prison."
Although St. Joseph London agreed to pay the $16.5 million, it did not admit violating the law, a common provison in such cases.. The hospital said it agreed to pay the penalty to avoid further expenses, "'uncertainty of prolonged litigation, and to allow the hospital to move forward.' It said the allegations arose in 'past relationships with some cardiologists who no longer practice at the hospital'," Wolfson reports.
St. Joseph President Greg Gerard said, "We are committed to providing the communities we serve with safe, high quality health care performed with the highest of integrity."
Three Central Baptist Hospital cardiologists in Lexington—Drs. Michael R. Jones, Paul W. Hollingsworth and Michael Rukavina—played a key role in discovering St. Joseph-London's malpractice, Estep reports. When they noticed that some patients they treated had been subjected to unnecessary procedures at London, they sued in 2011. "One patient who came to the Lexington practice had undergone 17 heart catheterizations—performed mostly by Patil—in London in four years, none of them necessary, according to the report," Estep writes. The three cardiologists will get $2,458,810 of the $16.5 million settlement, according to Harvey's office.
Although St. Joseph-London is finished with the civil portion of the case, the federal government will continue trying to get money from the doctors and clinics identified in the lawsuit, Harvey said. "This result would not be possible without the commitment of private citizens exposing this type of egregious fraud," said Perry K. Turner, special agent in charge of the FBI in Kentucky.
No comments:
Post a Comment