Recently, it has been reported in the New York Times and USA TODAY that stent, heart, and cardiac surgery and other types of medical procedures and care have been performed and billed to Medicare by certain doctors at an alarming rate and a high price. A USA TODAY Study found that tens of thousands of time each year, patients undergo surgery they simply don’t require.
Also, according to a USA TODAY analysis of the U.S. government’s National Practitioner Data Bank public use file, since 2005, over 1,000 medical practitioners have paid to settle or close malpractice claims in surgical cases that included allegations of needless or inappropriate procedures. It’s been found that many of the cases involve multiple plaintiffs, which indicates that there could be hundreds or even thousands of victims connected to one doctor or practice.
Statistics indicate that 28% of the top 100 Medicare billers have practices in Florida, with California having the second most (10%). There has been concern over many years by the federal government regarding doctors who perform a larger than usual number of surgeries, bill much higher than most other doctors, and receive millions from Medicare. Many times fraud is indicated in such instances, as doctors have been suspected of performing unnecessary surgeries, overbilling for medications and procedures, and taking advantage of government programs and consumers.
The American College of Cardiology has noted that there are various situations in which cardiac imaging may be ordered, but it is not necessary. Used in relationship with the scenarios below, these types of advanced technology tests are unlikely to reveal anything that would alter one’s treatment in a positive manner.
In an online article published by the Harvard School’s Harvard Health Publications, various situations are outlined regarding ACC recommendations as to when testing should not be done. These include when undergoing a routine risk assessment for heart disease and one is stable and symptom free; when a routine follow up for heart disease is being done and the patient is stable; and when one is being cleared for low-risk, noncardiac surgery. Also, the ACC does not recommend echocardiography, which is used to test heart vales, if one has mild, stable valve disease or if they present no symptoms at all, nor are stents recommended for coronary arteries that are not directly associated with a heart attack.
There is a major reason for concern for residents in Ocala and The Villages regarding a doctor who is the leading biller in the country for cardiac angioplasty, stents, coronary bypass and other types of cardiac surgery. As noted in major news sources, including USA TODAY and The New York Times, Dr. Asad Qamar, a cardiologist from Ocala, Fla., received over $18 million in one year for services to approximately 1,800 patients.
Qamar, whose medical practice includes the Institute of Cardiovascular Excellence and the Limbstitute, has seven offices in Ocala, The Villages, Williston, Summerfield and Tavares. Most of the questionable billings were for coronary bypass and stenting procedures.
According to reports by Reuters and various local news outlets in Florida, Qamar, whose reimbursements were being held up due to an extensive investigation of his billing procedures to Medicare, engaged in a letter writing campaign to the White House, federal agencies, and officials. In the campaign, he complained about the holdup. Despite his complaints, representatives from Medicare have noted that his billing practices are excessive and that the number of procedures performed is questionable.
Do you suspect that you have been the victim of unnecessary coronary, heart, or other related types of surgeries, or do you have a loved one who may have undergone a suspicious procedure? If so, you may fill out the simple contact form located on the right hand side of this page. After we receive this form, one of our intake specialists will provide you with a free, no obligation evaluation of your situation, helping you determine if you may have recourse for having had unnecessary surgery performed and if you have been the victim of Medicare fraud.
A 2011 study in the Journal of the American Medical Association of 112,000 medical records of patients who had an implantable cardioverter-defibrillator (ICD) revealed that in 22.5% of the cases researchers found no medical evidence to support installing the devices. An ICD is a pacemaker-like device that corrects heartbeat irregularities. Surgeries such as this puts patients at risk for various medical problems and complications, exposes them to undue pain, discomfort, and recuperative procedures, and makes them and taxpayers pay or procedures that were not needed.
If you have had surgery, does that mean that you have been the victim of Medicare fraud? The answer is, “No.” However, reports by various sources as noted above and the fact that the federal government has had serious questions concerning certain procedures, the cost and frequency of treatments, and the regional concentration of questionable surgeries raises numerous red flags.
If you believe that you may have been the victim of Medicare fraud and unnecessary, cardiac angioplasty, stents, coronary bypass or other cardiac surgery or testing in Ocala and The Villages, please note that we are scheduling FREE INFORMATIONAL LUNCH & LEARNS in both The Villages and Ocala. Date confirmation to come.
If you feel that you need to discuss your situation, please contact Steinger, Iscoe & Greene today. We will work hard to make sure that you receive justice.