Qui Tam

Medicare Paying for Hundreds of Improper Cardiac Stent Implantations

By Nolan and Auerbach

While investigating a doctor who reportedly implanted hundreds of potentially medically unnecessary stents, Senate investigators may have stumbled across a troubling nationwide practice that drains funds from government health care programs and needlessly places patients? lives at risk. In their released report, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) not only detail the relationship between this doctor and a medical device manufacturer, but they spotlight a possible pattern of wasteful, medically unnecessary stent implantations.

In this particular case, a Maryland doctor reportedly implanted nearly 600 potentially medically unnecessary stents from 2007 through mid-2009 at St. Joseph Medical Center in Towson, Maryland. According to the Senators? report, the questionable stent implantations cost the Medicare program $3.8 million during that period.

The Senators especially took note of the relationship between this wayward doctor and the manufacturer of stents, Abbott Laboratories. The report noted that Abbott placed the doctor on its ?Project Victory? list of top stent volume cardiologists and paid for at least two social events at the doctor?s home, including a barbeque and crab dinner, in 2008.  After St. Joseph Medical Center barred the doctor from practicing, Abbott Labs hired the doctor to promote and prepare safety reports on its stents in China and Japan.

All too often, pharmaceutical and medical device manufacturers will improperly leverage their relationships with doctors to drive up the companies? bottom lines. As seen in several recent False Claims Act settlements, these companies will shower doctors with lavish gifts, lofty ?Key Opinion Leader? titles, and mounds of cash, all with the intention of increasing prescriptions for their medical products.

The Senators? findings are a good reminder that all medical specialties are considered fair game when it comes to the bribes of dishonest drug and medical device makers. Unfortunately, most of these practices go undetected, to the detriment of patient safety and the Medicare Trust Fund. However, when a courageous individual steps forward to shine a light on these practices, a clear message is sent to the companies that their profits are not more important than the well-being of the American people.

For more information about qui tam law and Medicare fraud, contact Nolan and Auerbach, PA.

Full post as published by Medicare Fraud 101 on December 23, 2010 (boomark / email).