In 2012 and 2013, South Florida cardiologist Asad Qamar, M.D., had been one of Medicare's highest paid physicians in the country. Now, following lawsuits alleging that he routinely billed for unnecessary cardiac procedures, he is banned from billing Medicare entirely, according to the Ocala Star Banner.
In March, the Centers for Medicare and Medicaid Services (CMS) officially banned Qamar and his practice, the Institute for Cardiovascular Excellence (ICE), from billing federal health programs, following a 2.5 year investigation into his billing practices. In a letter to the cardiologist, CMS indicated the ban was based on "credible allegations of fraud" linked to claims that included excessive hours for certain procedures and services that lacked supporting documentation, according to the newspaper. CMS also cited specific dates in 2012 and 2013 in which Qamar billed for more than 24 hours in one day.
A representative of ICE denied the allegations, telling the newspaper that the Medicare suspension was "extortion." Qamar's attorney Tracy Mabry wrote to CMS, indicating the agency had already withheld $1.4 million, a figure she said would reach $2.5 million by the end of March.
Medicare payment data, first released by CMS last year, shows that Qamar's Medicare payments were far above average cardiology payments. Medicare paid Qamar $16 million in 2013, but the average Florida cardiologist made just $260,199.
Over the past year, health systems have also been entwined settlements for unnecessary cardiac procedures. Earlier this month, Westchester Medical Center paid $18.8 million to resolve allegations of unnecessary cardiac procedures. Last June, Kings Daughters Medical Center in Kentucky paid $40.9 million to settle claims regarding unnecessary cardiac stents and diagnostic catheterizations.
To learn more:
- read the Ocala Star Banner article
Justice Department joins whistleblower suits against high-billing Florida cardiologist
It's not perfect, but Medicare payment data a jumping-off point for fraud detection
CMS releases new physician, hospital payment data
Unnecessary procedures drive cardiology fraud investigations
Heart patients victimized by billing fraud, unnecessary procedures