Dr. Ashish Pal, a cardiologist based in Orlando, Florida, has paid $6.75 million to resolve allegations that he violated the False Claims Act by performing medically unnecessary ablations and vein stent procedures.
The settlement resolves allegations that, from Jan. 1, 2013 to Dec. 31, 2019, Dr. Pal knowingly submitted false claims to federal health care programs for medically unnecessary ablations and vein stent procedures. The government alleged that Dr. Pal performed the ablations and stent procedures on veins that did not qualify for treatment under accepted standards of medical practice. Additionally, the government alleged that Dr. Pal made misrepresentations in patient medical records to justify the procedures, including overstating the degree of reflux and diameter of veins, and falsely documenting patient symptoms. The United States also alleged that, in many instances, the ablations were performed either exclusively or primarily by one or more ultrasound technicians outside their scope of practice.
“Physicians are expected to perform procedures only when they have a legitimate medical basis to do so,” said Acting Assistant Attorney General Brian M. Boynton for Justice Department’s Civil Division. “The department will pursue those who waste taxpayer funds and subject patients to unwarranted medical care.”
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“Our office is committed to protecting vulnerable patients from those who put financial gain ahead of patients’ needs,” said Acting U.S. Attorney Karin Hoppmann of the Middle District of Florida. “We will continue to hold accountable those who abuse the nation’s healthcare programs at the expense of the taxpayers.”
“When physicians enrich themselves by performing medically unnecessary procedures on Medicare and Medicaid beneficiaries, they threaten their patients’ health and divert taxpayer funds meant to pay for necessary care,” said Special Agent in Charge Omar Pérez Aybar of U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG). “We will continue to work hard with our law enforcement partners to ensure that health care providers who engage in such abusive behavior are held accountable.”
“The healthcare providers within the Military Health System are committed to patient satisfaction and take seriously their obligation to ensure great outcomes by providing the highest-quality care,” said Director Lt. Gen. Ronald J. Place, M.D. of the Defense Health Agency (DHA). “We are grateful to the U.S. Department of Justice for working to maintain that trust by ensuring medical providers continue to put their patients’ needs and safety first.”