A California cardiology practice will pay $1.2 million to resolve allegations that doctors improperly performed and billed federal and state healthcare programs for medically unnecessary cardiovascular diagnostic procedures.
The settlement resolved allegations against Cardiovascular Consultants Heart Center, which has offices in Fresco and Clovis, that it submitted claims for cardiovascular nuclear imaging, also called nuclear stress tests, that were not medically necessary or reasonable, according to the U.S. Attorney’s Office for the Eastern District of California.
The settlement was made by the heart center and five M.D. shareholders: Kevin Boran, Michael Gen, Rohit Sundrani, Donald Gregory and William Hanks.
The doctors deny the allegations and say the settlement is not an admission of wrongdoing.
The U.S. Attorney’s office alleged that the doctors automatically scheduled patients for expensive nuclear stress tests on an annual basis without seeing them beforehand to determine that the procedure was necessary. The test exposes patients to a significant amount of radiation through the injection of radioactive dyes and the risk of an invasive procedure based on false positive results, the government said. A Centers for Medicare & Medicaid Services local coverage determination prohibits the use of the tests as a screening procedure.
The center’s attorney, Patric Hooper, told The Fresno Bee that rather than spend hundreds of thousands of dollars to litigate the case, the doctors reluctantly agreed to pay to settle the case in order to put it behind them.
The doctors wanted to get the results of nuclear imaging scans in advance of appointments with patients who had longstanding cardiac disease so they could review the results and discuss treatment, he said. “These doctors continue to be excellent doctors and this is anything but a fair resolution,” Hooper told the newspaper.
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