Cardiologist PAYS $2M to Resolve Unnecessary Medical Tests Claims
Michigan Cardiologist Group Pays $2 Million (US) to Resolve Unnecessary Testing Claims
Keywords
Cardiology, cardiac testing & procedures, unnecessary medical testing
At a glance
Intro:
This article discusses a recent case in Michigan where a Cardiologist and his medical group paid $2 million (US) in a long-running legal case to settle unnecessary medical tests claims.
Discussion:
- Legal and ethical concerns for Cardiologists regarding quantity and need for tests
- Concerns re oversight and its role in decisions to test or not
- Financial motivations to test
Conclusion: This case is a perfect example of where there is a clear need and purpose to consult a Cardiologist with the knowledge and experience required to evaluate the medical record to review the standard of care, testing, and treatment.
DISCLAIMER: Dr. Dalawari shares interesting and relevant medical-legal news in the press. He also shares case verdicts & settlements from the public record. He has no professional or personal relationship to the cases.
Today's Cardiologist is faced with highly complex decisions re both testing and treatment.
Exposing a patient to unnecessary radiation in pursuit of profit is clearly dangerous, and is, therefore, clearly a crime. In reality, a physician is exposed to being sued for anything from reckless endangerment to assault with a deadly weapon.
On the other hand, it may be a specific physician’s style of practice to be as thorough as possible. This could be seen by others as unnecessary testing.
Physician motivation/s for testing can be threefold:
- Fear of lawsuits due to tests not done resulting in missing/delayed diagnosis
- Fear of oversight resulting in over testing
- Financial gain
A best practice, although time-consuming, could be to provide a documented testing/treatment plan explaining the basis and need for any/all tests and procedures, and have the patient sign that they understand the "what, when, and why" for all.
This case is a perfect example of where there is a clear need and purpose to consult a Cardiologist with the knowledge and experience required to evaluate the medical record to review the standard of care, testing, and treatment.
A Cardiology specialist must have both the ability and experience needed to help evaluate and support or refute lawsuits based on the facts of the medical record.
Full Article Excerpt & Link
Article Excerpt:
This settlement concludes a multi-year investigation by the Office of Inspector General for the United States Department of Health and Human Services and the Defense Health Agency acting on behalf of the TRICARE Program. The State of Michigan Attorney General’s Office participated in the settlement as the State of Michigan was a named plaintiff in one of the cases.
“Physicians commit to providing and billing for only medically necessary services when they choose their profession and participate in federally funded health care programs,”
Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region
“Physicians commit to providing and billing for only medically necessary services when they choose their profession and participate in federally funded health care programs,” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region.
“To deviate from that commitment and potentially place their patient’s health and safety at risk as well as limited taxpayer resources is unacceptable. The OIG will continue to work with our federal, state, and local partners to ensure that patients and taxpayer dollars are protected.”
Conclusion:
A Cardiology specialist must have both the ability and experience needed to help evaluate and support or refute lawsuits based on the facts of the medical record.
This case is a perfect example of where there is a clear need and purpose to consult a Cardiologist with the knowledge and experience required to evaluate the medical record to review the standard of care, testing, and treatment.
DISCLAIMER:Dr. Dalawari shares interesting and relevant medical-legal news in the press. He also shares case verdicts & settlements from the public record. He has no professional or personal relationship to the cases.
Do you have questions about a medical case or need help understanding treatment plans and options?
Cardio Med Legal Dr. Jasdeep Dalawari
(804) 991-4109 - info@cardiomedlegal.com
References:
United States Department of Justice: https://www.justice.gov/usao-edmi/pr/cardiologist-dinesh-shah-pays-2-million-resolve-false-claims-act-allegations-relating