Cardiologist to pay $2M in excessive testing case
An Oakland County cardiologist has settled a civil case with the United States for allegations of excessive testing and collecting payment for it.
Dinesh M. Shah, MD and his practice, Michigan Physicians Group, agreed to pay $2 million to resolve allegations of violating the False Claims Act. Shah, the sole owner of MPG and a practicing cardiologist, allegedly billed federal health care programs for diagnostic testing that was either not needed or not performed.
MPG’s primary offices are in Berkley and Livonia. It also has administrative offices, testing sites and labs throughout metropolitan Detroit.
According to a news release from the U.S. Attorney’s Office, it’s alleged that from 2006 to 2017 Shah and MPG knowingly billed Medicare, Medicaid and TRICARE for blood pressure-related Ankle Brachial Index and Toe Brachial Index tests that were unnecessary or hadn’t been ordered by a physician.
It’s also alleged that Shah was routinely ordering unnecessary Nuclear Stress Tests and that MPG provided them. These tests use radioactive tracer to evaluate blood flow to the heart.
“Subjecting patients to unnecessary testing in order to fill one’s pockets with taxpayer funds will not be tolerated. Such practices are particularly concerning because overuse of some tests can be harmful to patients,” Acting U.S. Attorney Saima Mohsin stated in the news release. “With these lawsuits and the accompanying resolution, Dr. Shah and Michigan Physicians Group are being held to account for these exploitative and improper past practices.”
The settlement resolves allegations from former MPG employees who filed lawsuits under the whistleblower provisions of the False Claims Act. There’s been no determination of liability.
The allegations emerged after a years-long investigation by the Office of Inspector General for the United States Department of Health and Human Services and the Defense Health Agency The State of Michigan Attorney General’s Office participated in the settlement as the State of Michigan was a named plaintiff in one of the cases, the news release states.
“Physicians commit to providing and billing for only medically necessary services when they choose their profession and participate in federally-funded health care programs,” Lamont Pugh III, special agent in charge, U.S. Department of Health and Human Services, Office of Inspector General – Chicago Region, stated in the news release. “To deviate from that commitment and potentially place their patient’s health and safety at risk as well as limited taxpayer resources is unacceptable. The OIG will continue to work with our federal, state and local partners to ensure that patients and taxpayer dollars are protected.”
Along with the civil settlement agreement, Shah and MPG entered into an Integrity Agreement with the Office of Inspector General for the United States Department of Health and Human Services. That agreement will provide for some oversight of Shah and MPG’s billing practices for three years.