A Las Vegas-based cardiovascular surgical practice agreed to pay $1.5 million to resolve False Claims Act allegations that the organization overbilled federal health care programs including Medicaid and also billed for services it did not perform, the U.S. Department of Justice said Friday.
In an agreement involving the Offices of the Inspector General for the U.S. Department of Health and Human Services and the U.S. Department of Veterans Affairs, Cardiovascular and Thoracic Surgeons of Nevada Inc. settled the allegations regarding its billing practices for Medicare, U.S. military health program Tricare, and the Federal Health Employees Benefits Program.
According to the government, CTS, whose principal physician is Dr. Bashir Chowdhry, allegedly billed the programs for services it never actually rendered to cardiac patients, and also billed for certain surgical, evaluation and management services that were more expensive than what the facility actually provided. The scheme allegedly took place between January 2006 and May 2011, the government said. Approximately $695,000 of the $1.5 million penalty is restitution, the government said. The settlement is not an admission of liability, but also does not release any possible criminal liability, or administrative liability including suspension or exclusion from federal health care programs.
In its petition, the government contended that CTS failed to comply with document requests under the investigative demand, which pertained to the company’s billing practices. The government at the time said it sought to determine whether CTS had submitted any false claims to the Medicare or Tricare programs. The petition contained a set of heavily redacted documents containing the information sought by the DOJ. The U.S. District Judge in January 2013 granted the government’s motion, enforcing the investigative demand and ordering CTS to “produce the outstanding medical and financial patient information sought by the government.”