Ohio cardiologist, his practice agree to $1 million penalty - Beckley, Bluefield & Lewisburg News, Weather, Sports

Ohio cardiologist, his practice agree to $1 million penalty for filing false claims with Medicare

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An Ohio cardiologist and his practice will pay a $1 million penalty for submitting false claims to Medicare.

U.S. Attorney William J. Ihlenfeld II said the agreement with Dr. Devender Batra and Belmont Cardiology, Inc., ends an investigation into improper compensation arrangements between them and Ohio Valley Medical Center in Wheeling and its sister facility, East Ohio Regional Hospital in Martins Ferry, OH.

Batra, a cardiologist, is president of Belmont Cardiology.

Ihlenfeld said the arrangement with Batra and Belmont Cardiology caused the two hospitals to submit false claims for prohibited referrals for various health services from January 2009 to August 2010, a violation of the federal false claims act.

"These types of prohibited referrals are a significant problem and lead to increased health care costs for everyone," Ihlenfeld said. "Medicare expects that a physician's referral of a patient to a hospital will be free from improper influences, and when it's not we will act to hold the wrongdoers accountable."

The investigation arose after the U.S. Attorney's Office resolved claims against East Ohio Regional Hospital and Ohio Valley Medical Center for entering into improper compensation arrangements with Batra and others.

Referrals of patients that are motivated, to any degree, by prohibited compensation arrangements may lead to costly and unnecessary medical care. Ihlenfeld said they encourage anyone who has knowledge of such arrangements between a medical facility and a physician to report it.

"Sound medical decision making cannot be influenced by financial gain," said Nick DiGiulio, Special Agent in Charge for the Inspector General's Office of the U.S. Department of Health and Human Services in Philadelphia. "We are pleased that these allegations are resolved and will continue to work with the Department of Justice to root out illegal, wasteful business arrangements."

The False Claims Act is a federal law that allows the government to sue health care providers who submit false or fraudulent claims to federal health care programs, such as Medicare, or cause others to do so. False claims submitted by medical providers cost federal health care programs billions of dollars each year.

This matter was handled by Assistant United States Attorney Alan G. McGonigal, in coordination with the United States Department of Health and Human Services, Office of Inspector General.