The United States Department of Justice (DOJ) recently accused an internal medicine physician of reusing single use catheters. The government claims the physician would repackage the medical devices and reuse them during future procedures. These allegations are part of a larger set of criminal charges.
What were the criminal charges?
The DOJ was charged the physician with the following:
- Health care fraud. The government charged the physician with seven counts of health care fraud. These charges primarily included allegations of upcoding or using the wrong code to bill Medicare for medical services. The prosecution also accused the physician of recruiting Medicare beneficiaries to come to his clinics and then falsely diagnosing those beneficiaries with venous insufficiency. He would then prescribe, provide and bill Medicare for allegedly unnecessary vein ablation procedures.
- Adulteration of a medical device. The prosecution also accused the physician of repackaging the catheters used during the vein ablation procedures for re-use in future ablation procedures. These catheters were cleared by the FDA for single-use only.
The government claimed the physician submitted claims to Medicare for almost $12 million for the procedures and received $4.5 million in payment. The court reviewed the evidence and ruled in favor of the government, convicting the physician on seven counts of health care fraud and a single count of adulteration of a medical device.
The court will move forward with sentencing in March of 2020.
The case serves as a reminder that the government will come after individual physicians. The government can, and has, built successful cases against physicians. These cases often result in monetary penalties and prison time. As a result, any physician who is the subject of a government investigation is wise to act to protect their interests.