PHOENIX — A Phoenix-area cardiology office and three of its physicians have agreed to pay $4.75 million to settle allegations they performed medically unnecessary vein ablations and falsified records to justify the procedures, the U.S. Department of Justice announced.
Tri-City Cardiology, along with Drs. Jaskamal Kahlon, Joshua D. Cohen and Marc J. Berkowitz, was accused of violating the False Claims Act by billing Medicare, Medicaid, TRICARE and the Department of Veterans Affairs for the procedures from January 2017 to April 2022.
Tri-City Cardiology, which has offices in Chandler, Mesa and Gilbert, did not admit liability as part of this settlement. It denies the allegations.
A vein ablation is a procedure that uses heat to seal off damaged veins, such as varicose veins.
The government said the physicians performed ablations on patients that did not meet accepted medical standards for treatment.
Prosecutors allege the defendants falsified records of blood flow duration, vein diameter and patient symptoms to make the procedures appear justified.
“We strongly disagree with the government’s allegations and unequivocally deny that our physicians knowingly submitted false claims or performed medically unnecessary procedures,” Tri-City Cardiology said in a statement. “The care at issue was provided under the 2020 Appropriate Use Criteria and the Medicare ‘reasonable and necessary’ standard in effect at the time.”
The cardiology office added that there was no contention of patient harm or patient complaints and that it decided to settle to avoid prolonged litigation as well as focus on patient care. It also noted that it is still fully eligible to participate in Medicare and all federal health care programs.
Federal officials defend DOJ settlement
“Physicians should not prioritize profit over patient needs,” Assistant Attorney General Brett A. Shumate said in a Thursday announcement. “Medicare and other federal programs pay only for medical care that meets accepted standards, and the falsification of medical records undermines efforts to assess whether medical care was appropriate.”
U.S. Attorney Timothy Courchaine for the District of Arizona said paying for unnecessary procedures reduces federal programs’ capacity to cover necessary care.
“When medical providers do not respect the difference between the two and bill in the interest of their own bottom line instead of their patients, the United States Attorney’s Office has pursued and will continue to pursue appropriate recoveries to protect taxpayer funds,” Courchaine said.
Of the $4.75 million settlement, $4.6 million will go to the federal government and $2.3 million will be for federal restitution. Another $144,000 will go to the Grand Canyon State with around $72,000 being for restitution.
