Whistleblower attorneys at Pintas & Mullins Law Firm report of a recent settlement reached by Jackson Cardiology Associates, its owner and the federal government over medically inappropriate procedures. The fraud was reported by a cardiologist who now stands to receive up to $120,000 in the whistleblower suit.
Allegiance Health in Jackson, Mississippi was also part of the $4 million settlement for allowing many of the operations to take place there. The whistleblower, Dr. Julie Kovach, alleged that Jackson Cardiology Associates’ owner, Dr. Jashu Patel, routinely ordered catheterizations for patients based on false readings of nuclear stress tests.
Cardiac catheterizations are very serious medical procedures used to diagnose and treat certain heart ailments. During the procedure a long, flexible tube is inserted into a blood vessel and threaded to your heart, after which a cardiologist may conduct diagnostic tests and treatments. Physicians typically perform this procedure in hospitals, in this case at Allegiance Health, because it can cause serious complications.
In its investigation, the government found that about two-thirds of Patel’s patients had no significant heart blockages. Patients were also subjected to various other medically unnecessary tests, such as stenting procedures. Payment for these procedures came from Medicare and Medicaid, which is why the government was so quick to investigate and sue.
The government was able to sue the offenders under the False Claims Act, which also includes a qui tam provision allowing whoever initially informed of the fraud to receive some of the money damages. This has become known as “whistleblowing,” and those reporting are typically able to receive about 15 to 30% of the damages.
Once someone reports the fraud the government goes in to investigate, and after collecting evidence proving the illegal behavior, would ultimately file a lawsuit against the offender. In this particular case, Jackson Cardiology Associates settled for $2.2 million and Allegiance health for $1.8 million, though Allegiance admits no wrongdoing.
Jackson and Allegiance must also enter into an Integrity Agreement with the Office of the Inspector General and Department of Health and Human Services. This type of document outlines the obligations these facilities must adhere to as part of the settlement to keep participating in Medicare, Medicaid, and other federal health programs.
In related news, American hospitals reportedly spent $4 billion on adding angioplasty services in the past four years, however, the new services have done very little to improve patient access to timely medical care. This is because the invasive cardiac care units were built primarily near existing ones, rather than where the services were most needed.
This is evidenced by the fact that the percentage of the national population with timely access to angioplasty improved by less than 2% during the last four years. During those same years, the number of cardiac labs and clinics in hospitals increased by 16%.
Researchers note that this information illuminates that hospitals are much
more concerned with one-upping the competition than the health of the
general population. About one million angioplasties are performed every
year in the U.S., and it remains the best treatment for those experiencing
a heart attack or symptoms of coronary blockage.
There is still a considerable amount of the population (about 20%) that live further than one hour away from clinics providing angioplasties. Someone experiencing a heart attack does not have one hour to receive an angioplasty, and must therefore settle for lesser treatment options. Meanwhile, many hospitals in the U.S. are adding angioplasty services even though they are within a few miles of another hospital with one, merely to stay up on the competition.
Medical malpractice lawyers at Pintas & Mullins Law Firm have decades of experience advocating on behalf of those injured by negligent medical providers. If you or a loved one was subjected to unnecessary procedures or treatment, such as the patients at Jackson Cardiology Associates, you have important legal rights, and may be entitled to significant compensation for your pain and suffering.