Health system pays $1.8M over claims of unnecessary heart procedures

Allegiance Health this week has agreed to settle with the U.S. Department of Justice over allegations that the 480-bed community-owned health system in Jackson, Mich., billed Medicare and Medicaid for unnecessary cardiac procedures performed by one of its cardiologists, the DOJ announced Wednesday.

The lawsuit unsealed this week claims cardiologist Jashu Patel and other cardiologists employed by Jackson Cardiology Associates performed medically unnecessary cardiac procedures, including invasive catheterizations at Allegiance Health and a variety of other office-based tests.

Under the settlement, Patel and Jackson Cardiology Associates will pay $2.2 million and Allegiance Health will shell out $1.8 million. A portion of the $1.8 million will cover medically inappropriate peripheral stenting performed in the outpatient setting, the DOJ noted.

The settlement also enters Jackson Cardiology Associates and Allegiance Health into corporate integrity agreements with the government.

Allegiance Health denied any wrongdoing but decided to settle to avoid litigation costs, the health system announced. The system also said it has improved documentation requirements to ensure clear record keeping and substantiation of all cardiology procedures performed.

The false claims settlement with Allegiance Health joins 55 hospitals in 21 states that last week agreed to pay the government a total of more than $34 million to settle allegations they submitted false claims to Medicare for kyphoplasty procedures. 

To learn more:
- here's the Allegiance statement
- read the DOJ announcement

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