Friday, September 16, 2016

Medicare's second-highest paid doc accepts three-year exclusion

One of the country’s highest paid physicians agreed to a three-year exclusion to settle claims that he billed Medicare for medically unnecessary cardiac procedures, according tothe Department of Justice.

Last year, the DOJ joined two whistleblower lawsuits against Asad Qamar, who owned the Institute of Cardiovascular Excellence in Ocala, Florida. The lawsuits alleged that he regularly billed for unnecessary procedures and violated the Anti-Kickback Statute by waiving Medicare copayments. Months later, the Centers for Medicare & Medicaid Services banned Qamar from the Medicare program, prompting support from a Super PAC of former patients who were “disgusted and distressed” by the government’s portrayal of Qamar.
In addition to a three-year exclusion from Medicare, Qamar will pay $2 million and forgo an additional $5.3 million in suspended claims.
One thing to remember is that these occurences are rare. The real question is how medicare waits so long to act on these suspicious billings. The claims should be suspended pending adequate analysis.  The system needs to be proactive to avoid fraud and theft from the public tillers.
Fraud such as this is inexcusable, and the alleged perpetrator should have his medical license suspended  pending further analysis.  With this volume of surgery  his records also should be thoroughly examined. No doubt he owned his own surgery center and had no peer review. Were the procedures even indicated ?
These issues brought forth by the DOJ on behalf of CMS are difficult to analyze at times. There were a number of providers in this group and it may be that all were included under his billing identifications. No other providers were named in the action.
Here is the doctors letter of response to his patients. Bottom a fine, make retitution and you are still in business...all about money for the feds....not a real moral or ethical issue for them. Was he guilty.  I present.... you decide.  

Patients are easily fooled, especially if complication rates are low. Examine the Facebook pages of grateful happy patients. PR and marketing can be clever camouflage for deception and fraud

WebMD reports multiple physicians in this group. Dr Qamar may have been the only interventional cardiologists receiving referrals from the other cardiologists. The devil is in the details. It is a standard practice for cardiologists, and other interventional providers who no longer operate to see and diagnose patients with serious cardiac problems and refer them to someone who performs PCCT. It is also a proven fact that 'high volume' surgeons have fewer complications... We do not know all of the details which become murky and obscured by what is published by others. Either that or the doctor is a sociopath. Case closed.

Digital Health Space neither agrees or disagrees with any stipulated legal settlement between Dr Assad Qamar with CMS and/or HHS.  This is only opinion..
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