Qamar to be excluded for 3 years in any federal health care program.
AB Wire
Cardiologist Dr. Asad Qamar, from Ocala, Florida, and his practice, the Institute of Cardiovascular Excellence (ICE), will pay $2 million, plus release any claim to $5.3 million in suspended Medicare funds, to resolve a lawsuit alleging that they improperly billed Medicare, Medicaid and TRICARE for medically unnecessary procedures, and paid kickbacks to patients by waiving Medicare copayments irrespective of financial hardship, the Justice Department announced today.
Qamar also agreed to a three-year period of exclusion from participating in any federal health care program followed by a three-year Integrity Agreement with the Department of Health and Human Services Office of the Inspector General (HHS-OIG). The settlement relates to two consolidated lawsuits in which the United States intervened on Dec. 22, 2014, according to the Justice Department.
“Billing federal health programs for medically unnecessary procedures is unacceptable – not only does it waste taxpayer funds, but it also puts patients at risk,” said Principal Deputy Assistant Attorney General, Benjamin C. Mizer, head of the Justice Department’s Civil Division, in a statement.
The settlement resolves the government’s lawsuit claiming that Qamar and ICE billed Medicare, Medicaid and TRICARE for excessive, medically unnecessary and inadequately documented peripheral artery interventional services and related procedures. Many of the cardiovascular procedures for which Qamar and ICE billed Medicare and the other programs were not indicated by patients’ medical histories or records, or the severity of the patients’ symptoms.
The government also alleged that to help facilitate this false billing scheme, Qamar and ICE routinely and indiscriminately waived the 20 percent Medicare copayment, irrespective of the patient’s financial need.
Medicare copayments assure that patients have an incentive to be smart healthcare consumers and avoid unnecessary procedures. By waiving the required copayments indiscriminately, Qamar and ICE induced patients to agree to unnecessary and invasive procedures and other services. Qamar’s and ICE’s illegal conduct made him the highest paid Medicare cardiologist in the country in 2012 and 2013.
“Patient safety is of paramount importance,” said U.S. Attorney A. Lee Bentley III for the Middle District of Florida. “When a doctor performs medically unnecessary and invasive procedures on Medicare patients, federal healthcare programs are defrauded and, more importantly, patients’ lives and wellbeing are recklessly put at risk. This case shows our office’s steadfast commitment to holding medical providers personally responsible for their actions.”
The allegations resolved by today’s settlement were originally raised in two lawsuits filed pursuant to the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government when they discover evidence that defendants have submitted false claims for government funds and to receive a share of any recovery.
The False Claims Act also permits the government to intervene in such lawsuits, as it has done in these cases.