A Houston doctor has coughed up $1.8 million to settle charges of bilking Medicare and Medicaid in a scheme that allegedly involved unnecessary billing and violations of anti-kickback laws, federal officials said Thursday.
U.S. Attorney Alamdar S. Hamdani announced that 80-year-old Dr. Mohammad Athari and his associated diagnostic facilities have reached a settlement over alleged false claims submitted to Medicare Part B, carrying on with this practice from July 22, 2014, to July 10, 2017. Athari's tactics were thrown into daylight, accused of charging for services that didn't pass muster as either reasonable or medically necessary because the records or diagnoses of the patients didn't back them up, or unlicensed technicians botched them.
The deal also resolved accusations that from January 7, 2014, through January 8, 2021, Athari went against the Stark Law by billing for imaging procedures after referring patients to his own neurology clinics, according to a statement from the Justice Department. The Stark Law prohibits doctors from sending patients to facilities where they have a monetary interest, in a bid to prevent conflicts of interest.
"The Stark Law was enacted to ensure that a physician's clinical judgment is not corrupted by improper financial incentives," Hamdani said in a Justice Department press release. "Similarly, physicians that bill government healthcare programs must ensure they are billing for medically necessary services and not just maximizing their own income." Hamdani continued underlining that protecting government healthcare programs and taxpayer dollars alongside ensuring patients receive quality care is a continuing mission of their office.
Special Agent in Charge Jason E. Meadows from the Department of Health and Human Services - Office of Inspector General backed this sentiment, stating, "Personal financial incentives corrupt the medical decision-making process, leading to harm for patients and depletion of funds from federally funded healthcare programs." Meadows emphasized the agency's commitment to holding those who put profit before patient care accountable, a justice pursuit echoed in the echo chambers of hospitals and clinics across the nation.
This significant payday sprang from a whistleblower lawsuit filed under the False Claims Act, which allows a private party to bring forth a case on behalf of the United States and partake in any recovered loot. The whistleblowers in this story, stepping onto the stage of justice, will enjoy an 18% cut of Athari's settlement.
The investigation that led to Athari's pocketbook taking a hit involved several layers of law enforcement, including the U.S. Attorney's Office for the Southern District of Texas along with the Texas Attorney General's Office – Civil Medicaid Fraud Division, with a helping hand from the Health and Human Services folks. Assistant U.S. Attorney Melissa Green was at the helm, dealing with the matter.
It should be noted, for those keeping score at home, that Athari and his facilities have not admitted to the roll call of allegations; the settlement is not an admission of guilt, just a very expensive way to avoid a longer and messier court battle.
