Florida Heart Doctor Reaches Agreement in FCA Suit, Will Pay $2 Million to Settle

Thursday, July 14, 2016
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On June 30, 2016, a Florida heart surgeon agreed to pay $2 million and release any claims to $5.3 million in suspended funds allegedly owed to him because of allegations of improperly billing Medicare, Medicaid and TRICARE. He is doing this to resolve a False Claims Act (FCA) suit, sometimes called a "whistle blowers" or "qui tam" suit.  Dr. Asad Qamar of the Institute of Cardiovascular Excellence (Institute) in Ocala, allegedly ordered unnecessary tests on patients in exchange for Medicare payments, according to the U.S. Department of Justice.

The Settlement Agreement.

After nearly five years of litigation and filing Chapter 11 (which usually does not affect Medicare overpayments, false claims act proceeds, or fines) Dr. Qamar and the Institute also agreed to a three-year ban from participating in federal health care programs followed by a three-year corporate integrity agreement (CIA) with the Department of Health and Human Services Office of the Inspector General, according to the announcement. Click here to read more on this.

“Patient safety is of paramount importance,” A. Lee Bentley III, U.S. attorney for the Middle District of Florida, said in a statement, referring to this case. “When a doctor performs medically unnecessary and invasive procedures on Medicare patients, federal healthcare programs are defrauded and, more importantly, patients’ lives and well-being are recklessly put at risk.”

Prior Whistle Blower Claims.

The consequences above, stemmed from two previous whistle blower claims.  The first complaint from July 2011, accused Dr. Qamar of submitting claims for unreasonable and unnecessary tests that qualify for high reimbursement rates under Medicare. The second complaint, from June 2014, alleged over-billing for unnecessary procedures and billing for services that were never performed.

According to prosecutors, Dr. Qamar — who received more than $35 million from Medicare between 2012 and 2013, allegedly making him the highest-paid Medicare cardiologist in the country for those years—routinely and indiscriminately waived the 20 percent Medicare co-payment.  He did this, or so it is alleged, regardless of patients' financial needs and to convince them to agree to unnecessary procedures and services paid for by federal health care programs.  Routinely waiving co-pays and deductibles is an easy way to get into big trouble with the Medicare Program and other government payors.

To read more on the whistleblowers in the FCA suit, click here.

Although Dr. Qamar and ICE filed a joint notice of settlement with the U.S. and Florida governments, the agreement included no admission of wrongdoing, and Dr. Qamar's counsel  continued to deny the allegations. To read the settlement in full, click here.

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Hale, Nathan. “Fla. Heart Doc To Pay $2M To Settle FCA Suit.” Law360. (June 30, 2016). Web.

Landolo, Mark. “U.S. OKs agreement with Institute of Cardiovascular Excellence over alleged improper billings.” Legal News Wire. (June 30, 2016). Web.

About the Author:
George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawfirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone; (407) 331-6620.

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"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 2016 The Health Law Firm. All rights reserved.


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