Clinician Crime: April 2024 Round-Up

Oncology Practice Pays Over $1 Million to Settle Kickback Scheme

Physicians at a hematology and oncology practice in Texas have agreed to pay over $1.3 million to resolve alleged violations of the False Claims Act. The practice had entered into an unlawful kickback arrangement with a diagnostic reference laboratory, which provided in-office bone marrow biopsies and subsequent diagnostic testing. 

The practice received $115 for each biopsy referral, which the government contended constituted a kickback under the Anti-Kickback Statute. The settlement also resolves claims that the physicians at the practice provided medically unnecessary tests, services and treatments that were billed to federal health care programs. The lab has agreed to pay over $2.7 million to settle the False Claims Act allegations. 

Commenting on the case, Special Agent in Charge Jason E. Meadows with the US Department of Health and Human Services Office of Inspector General, said: “Violations of the Anti-Kickback Statute involving oncology services can waste scarce federal health care program funds and corrupt the medical decision-making process. Individuals who participate in the federal health care system are required to obey laws meant to preserve both the integrity of program funds and the provision of appropriate, quality services to patients.”

Hospital Nurse Steals Pain Medications From New Mothers 

A nurse working in the labor and delivery unit of an Iowa hospital was sentenced to federal prison for stealing pain medication from at least 50 new mothers. Rather than administering the medications to the patients, the nurse stole the Schedule II narcotics for herself and then documented that the drugs were administered to the mothers.

As a result of her actions, the mothers suffered in terrible pain and were delayed or denied further treatment because it was assumed they had already received a narcotic analgesic. It was revealed during the plea hearing that the nurse had also tampered with fentanyl vials, replacing the medication with saline and diverting it for her own use. She also admitted to routine drinking and marijuana use while working at the hospital. In order to pass the hospital’s drug test, the nurse used another person’s urine. As part of her plea deal, the nurse forfeited her nursing license and was sentenced to 1 year and 1 day in federal prison.

Anesthesiologist Serves Up Cocktail of Dangerous Drugs to Patients

An anesthesiologist from Texas was convicted of tampering with intravenous (IV) bags resulting in several patients suffering cardiac emergencies during routine medical procedures. The anesthesiologist would inject IV bags of saline with epinephrine, bupivacaine and other drugs and then place them into a warming bin for use. 

During the surgeries, patients would experience dangerous complications such as unexpected rises in blood pressure; the issues all occurred shortly after the IV bags had been hung. A month after these emergencies began, another anesthesiologist at the center died after treating herself for dehydration with an IV bag. Following this incident, an 18-year-old patient ended up in the intensive care unit after a routine sinus surgery. An analysis of the fluid in the IV bag used during the teenager’s surgery showed that it contained bupivacaine, epinephrine, and lidocaine. 

At trial, it was discovered that the anesthesiologist was facing disciplinary action for an alleged medical mistake and that he faced losing his medical license. He now faces a maximum penalty of 190 years in prison. 

Commenting on the case, US Attorney Leigha Simonton for the Northern District of Texas, said: “[The anesthesiologist] assembled ticking time bombs, then sat in wait as those medical time bombs went off one by one, toxic cocktails flowing into the veins of patients who were often at their most vulnerable, lying unconscious on the operating table. We saw the patients testify. Their pain, their fear and their trauma was palpable in that courtroom.”

Cardiologist Busted for Submitting Fake Claims for Office Visits

A NJ cardiologist has admitted to participating in a health care fraud scheme leading to over $1.9 million in insurance reimbursements for false claims. In one case, the doctor submitted a claim for office visits that lasted approximately 1675 minutes for 1 day’s worth of visits. He also billed for over $800,000 for office visits while he was out of the country. Additionally, claims for office visits were submitted when only prescriptions were being picked up for controlled substances at the front desk. 

According to the US Attorney’s Office, District of New Jersey, a charge of health care fraud carries a possible sentence of up to 10 years in prison and a fine of up to $250,000 or twice the gain or loss from the offense, whichever is greater. 

Physician Pays Hefty Fine for Poor Recordkeeping 

An Oklahoma doctor has agreed to pay $200,000 to settle civil penalty claims related to his failure to maintain controlled substance records as set forth in the Comprehensive Drug Abuse Prevention and Control Act of 1970. According to the Act, registrants seeking to purchase controlled substances need to fill out the purchaser portion of a DEA Form-222; the purchaser is then required to retain a copy of the form, which includes the date and quantity of the products received. Registrants who do not follow all the necessary steps related to the Act can face monetary penalties, as failure to comply can increase the potential for drug diversion.