Follow-up home visits from a physician's assistant reduced complications and costs associated with cardiac surgery, according to a new study. The visits also led to a drop in the rate of readmissions.
An Ohio cardiologist sentenced last week to 20 years in prison for convincing patients to undergo unnecessary tests and procedures says the government used the Affordable Care Act to target him, according to The Guardian.
The issue of unnecessary cardiac procedures has been building momentum for years, and fraud investigators are certainly well aware of the amount of federal dollars that circle the drain thanks to the trend. The problem, however, is that unnecessary procedures are difficult to identify based on claims data alone. Cardiologists may be the key to self-policing a specialty that is quickly spiraling out of control.
Lucrative reimbursement for cardiac procedures in Medicare's fee-for-service model is at the heart of an investigation involving three Indiana surgeons accused of performing unnecessary surgeries on hundreds of patients while the hospital turned a blind eye, according to The New York Times.
A cardiologist in Ohio has been convicted for overbilling Medicare $7.2 million for unnecessary cardiac procedures including stents, catheterizations, nuclear stress tests, and recommending patients for cardiac bypass surgery that wasn't medically necessary, according to the U.S. Attorney's Office for the Northern District of Ohio. Meanwhile, a Kentucky cardiologist is awaiting trial after pleading not guilty to 27 counts of fraud and making false statements tied to unnecessary cardiac stents.
In 2012 and 2013, South Florida cardiologist Asad Qamar, M.D., had been one of Medicare's highest paid physicians in the country. Now, following lawsuits alleging that he routinely billed for unnecessary cardiac procedures, he is banned from billing Medicare entirely, according to the Ocala Star Banner.
Westchester Medical Center's recent $18.8 million settlement resolving allegations of unnecessary cardiac procedures has raised patient safety concerns, along with questions about the potential for fraud and abuse among cardiology providers.