Former health leader pays $1.5M to settle fraud case
Doctor denies taking shortcuts on colonoscopies
A former president of the Harris County Medical Society and his diagnostic and surgical center have agreed to pay more than $1.5 million to settle allegations of Medicare fraud.
The U.S. Department of Justice on Wednesday announced the agreement, which concerns allegations that Dr. Gurunath Thota Reddy and other doctors at Memorial Hermann Endoscopy and Surgery Center in North Houston over a seven-year period performed colonoscopies so quickly that they were “essentially worthless.”
“When Medicare pays for a patient to undergo a medical procedure, Medicare expects the health care provider to follow established medical standards of care and sanitation,” Abe Martinez, acting U.S. attorney, said in a news release. “There is no excuse for short-cutting quality in order to increase revenues.”
The department said the claims resolved are only allegations and that no liability in the matter has been determined.
The other parties who entered into the agreement are the United Surgical Partners International, which operates the center; Digestive & Liver Disease Consultants PA, the doctors’ practice; and the Memorial Hermann Health System, a minority owner in the joint venture. The center is not located on one of the system’s campuses.
Gene Besen, the practice’s lawyer, said in a statement that the settlement was made “solely to avoid the cost of defending the allegations and to continue to serve the community with the highest quality of care and standards as they have done for the last three decades.” He said the doctors consistently have and repeatedly denied the allegations.
Memorial Hermann, the Harris County Medical Society and USPI all declined comment.
The matter was initiated by an endoscopy nurse formerly employed by the center. She claimed that, in the interest of saving time, doctors would not always examine the entire colon and sometimes would spend as little as two minutes on a colonoscopy, short cuts that could have caused precancerous lesions to be missed.
The nurse said she was fired the day after she complained to the regional vice president of USPI about the problems. Besen disputed the timing and reason for the dismissal.
The news release did not name the nurse.
The nurse also alleged the surgery center did not follow established guidelines for sanitation, claiming Reddy would not put on a clean gown prior to each procedure in order to save money.
The claims date from April 1, 2007, through Nov. 30, 2014.
Reddy’s LinkedIn page says he was the first Asian to serve as president of Harris County Medical Society and that he did his training in gastroenterology, liver disease, transplant hepatology and nutrition at Baylor College of Medicine.