Tri-City Cardiology, P.C., a physician group based in the metro area of Phoenix, Arizona, and three individual physicians, have agreed to pay $4.75 million to resolve allegations that they violated the False Claims Act by performing medically unnecessary vein ablations.
“Physicians should not prioritize profit over patient needs,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “Medicare and other federal programs pay only for medical care that meets accepted standards, and the falsification of medical records undermines efforts to assess whether medical care was appropriate.”
“Paying for unnecessary medical procedures reduces federal programs’ capacity to pay for truly necessary procedures,” said Timothy Courchaine, United States Attorney for the District of Arizona. “When medical providers do not respect the difference between the two and bill in the interest of their own bottom line instead of their patients, the United States Attorney’s Office has pursued and will continue to pursue appropriate recoveries to protect taxpayer funds.”
The civil settlement announced resolves allegations that, from January 1, 2017, to April 27, 2022, Dr. Jaskamal Kahlon, Dr. Joshua D. Cohen, and Dr. M. Joshua Berkowitz knowingly performed ablations on perforator veins that did not qualify for treatment under accepted standards of medical practice. Perforator veins are small veins that connect deep and superficial leg veins and require treatment only in certain circumstances. The United States contends that Tri-City and the physicians acted knowingly in incorrectly measuring or documenting in medical records the duration of outward blood flow, the diameter of veins, patient symptoms, and conservative therapy measures, which gave the appearance that the ablations met accepted medical standards and were justified.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the United States Attorney’s Office for the District of Arizona, with assistance from HHS-OIG.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to HHS at 800-HHS-TIPS (800-447-8477).
The matter was handled by Senior Trial Counsel Nicholas C. Perros of the Civil Division’s Commercial Litigation Branch, Fraud Section and Assistant U.S. Attorney Lon Leavitt of the District of Arizona.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
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