December 8, 2023

Florida Cardiology PA, and 10 cardiologists within the follow have agreed to pay the US authorities and the state of Florida $2 million to resolve allegations that they violated the False Claims Act by submitting inflated claims to Medicare and Medicaid and billing whereas the physicians weren’t within the US, the Division of Justice has announced.

The lawsuit and settlement relate to the submission of claims that had been improperly billed or carried out and submitted or induced to be submitted by Florida Cardiology and its staff Sandeep Bajaj, MD, Abbas Ali, MD, Karan Reddy, MD, Claudio Manubens, MD, Milan Kothari, MD, Saroj Tampira, MD, Sayed Hussain, MD, Raviprasad Subraya, MD, Harish Patil, MD, and Edwin Martinez, MD.

In accordance with the lawsuit and settlement settlement, Bajaj and Reddy induced Florida Cardiology to invoice for extra intravascular stents than had been really inserted into sufferers; Bajaj induced Florida Cardiology to invoice for radiofrequency ablations that weren’t carried out by him and in some situations, weren’t carried out by a qualifying supplier; and all 10 cardiologists induced the corporate to invoice for procedures and companies whereas they had been exterior the US, which suppliers cannot do, besides in restricted circumstances.

Firm Denies All Allegations

In a press release emailed to Medscape Medical Information, Florida Cardiology stated it “adamantly and vehemently denies any and all allegations raised on this civil lawsuit with the US authorities.”

“Over the previous 40 years, Florida Cardiology has been a champion for affected person alternative, high quality, and worth within the supply of healthcare,” the assertion notes. “This settlement was reached by our attorneys with a purpose to forestall the expense and inconvenience of additional litigation.”

The settlement resolves claims introduced below the qui tam (whistleblower) provisions of the False Claims Act by Derrick Graham and Jesse Frauenhofer.

Below these provisions, a non-public social gathering can file an motion on behalf of the US and obtain a portion of any restoration. Graham and Frauenhofer will obtain $420,000 of the proceeds from the settlement with the defendants.

“Healthcare professionals taking part in Medicare and Medicaid are anticipated to abide by guidelines meant to guard sufferers, and to correctly invoice the applications on which their sufferers rely. Physicians who put monetary acquire above the well-being of sufferers and the integrity of federal healthcare applications might be held accountable for his or her actions,” Omar Pérez Aybar, with the US Division of Well being & Human Providers Workplace of Inspector Basic, stated in a DOJ information launch.

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