Insurance Fraud NEWS
Medicare's second highest-paying doc performed unnecessary heart procedures
July 05, 2016, Washington, DC
One of the country’s highest paid physicians agreed to a three-year exclusion to settle claims that he billed Medicare for medically unnecessary cardiac procedures, according to the Department of Justice.
Last year, the DOJ joined two whistleblower lawsuits against Asad Qamar, who owned the Institute of Cardiovascular Excellence in Ocala, Florida. The lawsuits alleged that he regularly billed for unnecessary procedures and violated the Anti-Kickback Statute by waiving Medicare copayments. Months later, the Centers for Medicare & Medicaid Services banned Qamar from the Medicare program, prompting support from a Super PAC of former patients who were “disgusted and distressed” by the government’s portrayal of Qamar.
In addition to a three-year exclusion from Medicare, Qamar will pay $2 million and forgo an additional $5.3 million in suspended claims.
Qamar was Medicare’s second-highest paid physician in 2012, earning $18.3 million. In 2013, he made $16 million, more than seven times the amount received by the next highest earning Florida cardiologist, according to data collected by ProPublica.
Unnecessary cardiology procedures have been a focal point for government investigators over the last year, and some have questioned whether Medicare’s fee-for-service model incentivizes unnecessary surgeries.
Source: Fierce Healthcare