Wednesday, January 25, 2012

Another cardiologist whistleblower case -- AMA concludes 12 percent of angioplasty surgeries nationwide are "inappropriate"

A cardiologist is suing what is now UPMC Hamot, claiming the Erie, Pa., hospital and physicians allegedly performed unnecessary angioplasty procedures and other surgeries while defrauding Medicare from 2001 to 2005, the Erie Times News reported. Tullio Emanuele, the cardiologist once affiliated with Hamot Medical Center, is accusing the hospital of engaging in sham contracts with Medicor Associates Inc. and its affiliate, Flagship Cardiac, Vascular and Thoracic Surgery of Erie that amounted to kickbacks in exchange for referrals.
The suit claims that one patient died after undergoing a heart catheterization that he did not need, and another patient died from complications from unnecessary bypass surgery.  "As the result of the fraudulent practices," Emanuele says in the suit, "Medicare overpaid for cardiac and vascular surgical and diagnostic services for its beneficiaries. Those patients were placed at significant and unnecessary risk of harm, and substantial public dollars were wasted."
The Erie-Times News broke the story.  This startled me:
The claims, made in a whistle-blower suit filed in U.S. District Court in Erie, come as the national medical community is scrutinizing angioplasty procedures, which commonly include the insertion of stents -- tiny mesh metal tubes meant to keep an artery open and improve blood flow.

A study published in the Journal of the American Medical Association in July found 12 percent of angioplasty procedures nationwide were "inappropriate."

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