For­mer health leader pays $1.5M to set­tle fraud case

Doc­tor de­nies tak­ing short­cuts on colono­scopies

Houston Chronicle - - CITY | STATE - By Todd Ack­er­man todd.ack­er­

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.

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