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mahatmakanejeeves

(56,710 posts)
Tue Jun 24, 2014, 03:42 PM Jun 2014

FBI Probes Medicare Billing at Los Angeles Clinic

FBI Probes Medicare Billing at Los Angeles Clinic

U.S. News
Investigation Looks at Whether Facility Overprescribed Rare Cardiac Treatment

By Christopher S. Stewart, John Carreyrou and Christopher Weaver
June 22, 2014 7:04 p.m. ET

The Federal Bureau of Investigation is examining a Los Angeles clinic that collected more than $2 million from Medicare in 2012 for a rarely used cardiac treatment, according to people familiar with the matter. ... In a page-one article earlier this month about some doctors' Medicare billings, The Wall Street Journal showed that the clinic collected more for the treatment than any provider in the nation by a large margin. Internal company documents reviewed by the Journal indicate that the clinic, which is owned by internist Ronald S. Weaver, and an affiliated lab collected about $17.5 million from Medicare between early 2006 and late 2012.

At issue in the active FBI probe is whether the clinic, Global Cardio Care Centers, is overprescribing the treatment, which is called "enhanced external counterpulsation," at taxpayers' expense, according to the people familiar with the investigation. EECP is administered by strapping a patient to a bed with three large cuffs that inflate and deflate rhythmically to increase blood flow through the arteries.
....

Dr. Weaver, who isn't a cardiologist, said in one email that he employs two to three cardiologists who prescribe EECP to patients when it "is medically necessary and appropriate."
....

While the clinic bills Medicare under Dr. Weaver's name, the driving force behind it is Sara Soulati, according to former employees. Ms. Soulati, who isn't a doctor, owns the company that manages the clinic and a neighboring lab that the clinic sends patients to for diagnostic testing. She promotes EECP throughout the community as a broad preventive measure against heart disease and prods her staff to gather up patients, former employees say.
....

Write to Christopher S. Stewart at christopher.stewart@wsj.com, John Carreyrou at john.carreyrou@wsj.com and Christopher Weaver at christopher.weaver@wsj.com


I know I'm going to get in trouble, but I think this comment is funny:

Howard Tyson
1 day ago

My suggestion to the physicians at the clinic under investigation is that they tell the FBI and Medicare that this was all discussed two years ago in numerous email exchanges between the clinicians, CMS, and the Feebs. CMS specifically approved a continuation of payments, and the Feebs agreed to drop the investigation. Unfortunately, the hard drive containing all of the relevant emails crashed. The clinic brought in a computer repairman from the local Staples outlet. He looked over the hard drive and said that the data could not be recovered, so the clinic sold the hard drive to a recycler to be melted down.

Hey, that worked for the IRS, it's bound to work for the good doctors at the clinic.

Yes indeedy!
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