OCALA – A Central Florida cardiologist has agreed to settle claims that he provided unnecessary procedures to patients covered by Medicare, Medicaid and TRICARE.
Kirk Ogrosky is a partner at Arnold & Porter | http://www.arnoldporter.com/en/people/o/ogrosky-kirk
Dr. Asad Qamar has not admitted wrongdoing in the case. Still, he and his Institute of Cardiovascular Excellence (ICE) facility have agreed to pay $2 million and release applicable claims to $5.3 million in suspended Medicare funding.
As part of the settlement, he also will agree to exclude himself and ICE from providing services under any federal health care program for a period of three years.
The doctor allegedly offered kickbacks to patients in the form of waiving their co-pays, which were designed to incentivize patients to make smarter health care decisions and not purchase procedures that are not needed.
The Department of Justice civil division also intervened in the case and publicly stated that the doctor not only wasted public funds, but put patients' health at risk when providing peripheral artery interventions that weren't needed.
“Billing federal health programs for medically unnecessary procedures is unacceptable – not only does it waste taxpayer funds, but it also puts patients at risk,” Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division, said in a press release. “Today’s settlement evidences the Department of Justice’s firm commitment to protect public funds and to safeguard the well-being of federal health care program beneficiaries.”
According to a letter obtained by the Florida Record, patients and staff were not pleased with the decision to settle. A group of them contacted a mediator and consultant to help resolve the matter.
The mediator, Richard I. Fine, wrote to Assistant Inspector General for Legal Affairs Robert DeConti, and said the staff and patients would be adversely impacted by the exclusion from federal health care program because they would face higher medical costs and less competitive health care options. Their deductibles may be too costly as well, Fine wrote in the letter sent to the government on June 20 in an attempt to resolve their complaints about the proposed settlement.
"Their concern has reached the level of instituting a 'hunger strike' to prevent the proposed settlement amongst other actions," the letter stated.
The lawsuits were filed pursuant to the qui tam whistle-blower provisions of the False Claims Act (FCA). This allows the federal government to intervene in cases such as this; however, Kirk Ogrosky, a former DOJ health care fraud expert who founded a specialty team in Miami to investigate medical fraud cases, said the government's claims are misleading and even harmful to consumers and taxpayers.
Media sources reported the cardiologist was the highest-paid Medicare doctor from 2012 and 2013, but Ogrosky said the media and government have jumped to conclusions and that these figures do not represent reality.
"Dr. Qamar was part of a group practice with 12 physicians and over 200 employees in an out-patient ambulatory surgical setting billing under a group number for ICE," Ogrosky told the Florida Record in an email. "The notion that his individual billing was the 'highest' or even that he was an outlier is simply mistaken. This case is an example of the media and government jumping to incorrect conclusions based on the misuse of statistics and data. Claims and payment data are certainly relevant, but repeating untrue assertions about the level of his billing is ill-informed and has caused tremendous damage to the doctor, his practice, but most importantly the patients and the Medicare program. Since ICE has gone into bankruptcy, many of his former patients are now seeking treatment in an in-patient setting and costing the taxpayers far more for each procedure."
Ogrosky thinks Qamar should have been afforded the right to defend himself and his practice in a court of law.
"The government has tremendous power and took away Dr. Qamar’s ability to defend himself in court," he said. "Our Constitution and government should protect the rights of those falsely accused to be able to have their day in court. When the government refuses to reveal the true facts, cuts off all payments, freezes earned funds, and initiates legal proceedings that require funds to defend, it puts citizens in an untenable position. As of today [July 15], Dr. Qamar has reached an agreement with the government and has not admitted any wrongdoing. This settlement was done to avoid any further expenses due to the litigation. In is a sad day when patients and taxpayers suffer at the hands of people who should be trying to protect their interests."