WASHINGTON (TIP): An Indian- American cardiologist has pleaded guilty to charges that he falsely recorded the severity of patients’ illnesses in order to receive payment for numerous heart procedures. Sandesh Rajaram Patil, 51, a former doctor at a hospital in Kentucky, is the third cardiologist in the United States to be federally prosecuted for health care fraud related to the placement of heart stents, according to the US Attorney’s Office.
The Justice Department said Patil admitted on Tuesday to making false statements regarding the placement of heart stents, the metal tubes surgically inserted into a patient’s arteries in order to improve blood flow. Patil reached an agreement with the US Attorney’s Office to serve a prison term between 30 and 37 months, pending a judge’s approval. Patil is scheduled for sentencing on August 27. St Joseph’s hospital has repaid the government USD 256,800 for cardiac stent procedures that Patil falsely submitted for reimbursement in 2009 and 2010.
“Dr Patil violated the public’s trust in physicians,” said Kerry B Harvey, US Attorney for the Eastern District of Kentucky. For a cardiac stent procedure to qualify as a medical necessity, it is generally accepted that a patient must have at least 70 per cent blockage of an artery and symptoms of blockage. Patil admitted that he placed stents in arteries that had substantially less than 70 per cent blockage. He nonetheless recorded blockage of 70 per cent or more in patient documents to guarantee payment from Medicare and Medicaid.