Prominent cardiologist admits record $19 million medical billing fraud scheme (USA)

A cardiologist with offices in New York City and New Jersey carried out what federal authorities called the largest health care fraud ever recorded by a single practitioner in those states. Federal prosecutors said 68-year-old Jose Katz of Closter, N.J., admitted to submitting $19 million in fraudulent billings to Medicare, Medicaid and private insurers. Prosecutors said he subjected thousands of patients to unnecessary and potentially life-threatening treatments as a result of phony diagnoses. "After years of prominence in his field, Jose Katz will now be remembered for his record-setting fraud," said U.S. Attorney Paul Fishman. "Katz was so focused on illegal profits that he directed unlicensed and unqualified providers to treat his patients, ordered unnecessary tests and cavalierly ordered treatments that could have caused patient harm. Ripping off the government and insurance companies is bad enough; risking patient health in the bargain is inexcusable," said Fishman. Katz also admitted keeping his wife on his payroll, even though she did little or no work, so she would be eligible for a quarter-million dollars in Social Security

Salisbury doctor found guilty of health care fraud (USA)

A Salisbury cardiologist faces as many as 35 years in prison after a federal jury this week found him guilty of six counts of health care fraud. A federal jury in Baltimore on Tuesday convicted John R. McLean, 59, of Salisbury, on six healthcare fraud offenses in connection with a scheme during which he submitted insurance claims for inserting unnecessary cardiac stents, ordered unnecessary tests and made false entries in patient medical records in order to defraud Medicare, Medicaid and private insurers. McLean faces a maximum sentence of 10 years in prison for health care fraud and five years for each of five counts of making false statements related to health care matters. The government is also seeking a forfeiture of over $700,000 believed to be the proceeds of the scheme

Baltimore hospital hit with 104 lawsuits alleging unessessary stenting (USA)

'The St. Joseph Medical Center (SJMC) in Baltimore has been slapped with 104 lawsuits, all which accuse Mark Midei, MD, former cardiologist at the facility, of committing medical negligence after it was found that he may have implanted hundreds of unnecessary stents in cardiac patients. Earlier this year, 585 patients received word from SJMC that their cardiac stent procedures may have been unwarranted and a 19-page lawsuit was filed in Baltimore by Murphy PA and the Law Offices of Peter G. Angelos, PC, against Midei. On Sept. 30, attorney Jay Miller and his firm Miller, Murtha & Psoras in Lutherville, Md., filed the suits against SJMC. “The lawsuits were filed because of St. Joseph’s absolute refusal to be fair to the very patients they sent letters to informing them that they had a stent placed that was not needed,” Miller said in a press statement" - TriMed Media Group

Patients learn they might have unneeded stents (USA)

St. Joseph Medical Center in Towson, Maryland, USA whose cardiology business is a focus of a continuing federal health-care fraud investigation, has notified hundreds of its heart patients that they may have received expensive and potentially dangerous coronary implants they didn't need. An internal review, begun last May at the behest of federal investigators and in response to a patient complaint, has turned up 369 patients with stents that appear to have been implanted in their arteries unnecessarily, CEO Jeffrey K. Norman said. Patients began receiving letters alerting them to the finding early last month, and more notifications are expected as the review continues. "We take our interaction and the care of our patients with the utmost seriousness, and so we wanted to alert patients and their physicians to what we found," said Norman. In several cases reviewed by The Baltimore Sun, patients who received coronary stents at St. Joseph - purportedly to open a clogged artery to correct a severe blockage - have since learned they had only minor blockage, if any. Vicki Marrs, pictured, a 55-year-old patient from Conowingo, is typical. She got a stent in July 2008 after arriving at St. Joseph's with chest discomfort and being told one of her arteries was 90 percent blocked. Now doctors and lawyers who have reviewed her files say Marrs had only a 10 percent blockage at most, and that she never suffered from the kind of heart disease described by Doctor Midei 18 months ago