FWA (NC)- Eastern District of North Carolina | Fayetteville Cardiologist Agrees to Pay Over $5 Million to Resolve Allegedly False Medicare and Medicaid Claims

MM Curator summary

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[MM Curator Summary]: Hari did lots of unnecessary cardiac procedures to steal $5M of your tax dollars. He did not say thank you.



Clipped from: https://www.justice.gov/usao-ednc/pr/fayetteville-cardiologist-agrees-pay-over-5-million-resolve-allegedly-false-medicare

RALEIGH, N.C. – Fayetteville, North Carolina cardiologist Dr. Hari Saini and his current practice, Carolina Heart and Leg Center, P.A., agreed to pay $5,015,554 to the United States and North Carolina to resolve allegedly false Medicare and Medicaid claims. 

“This civil fraud settlement demonstrates our steadfast commitment to protect taxpayer money and guard the integrity of our vital health care programs,” said U.S. Attorney Michael Easley.  “Medical doctors should never bill for unnecessary procedures.  Those who do will be held accountable.  Our office will zealously pursue damages and civil penalties against medical professionals where warranted.”

This settlement arose from whistleblower allegations that Dr. Saini and his cardiology practice performed unnecessary atherectomy procedures to remove minor plaque blockage in leg arteries in patients.  The United States filed a complaint against Dr. Saini, Carolina Heart and Leg Center, and Carolina Cape Fear Medical Group, alleging that Defendants “systematically overstated the stenosis percentage” to justify medically unnecessary atherectomies for the maximum number of procedures for their patients. More specifically, the Government alleged that Dr. Saini—who was one of the highest billing cardiologists in North Carolina for this type of claimconducted “risky and invasive atherectomy procedures to unnecessarily remove plaque blockage that was, at best, only minimally present, all in blatant disregard for patient safety and Program billing requirements.”  Based upon billing and medical records, Defendants were paid millions from Medicare and Medicaid, which the Government alleged was not supported by the retained medical records for the services provided and billed. 

Ultimately, after six years of discovery and litigation, and with trial looming, Dr. Saini and his practice agreed to pay more than $5 million to resolve the False Claims Act allegations. 

“Physicians cannot perform procedures on patients who don’t need them just to make more money,” said Attorney General Josh Stein. “That’s a waste of taxpayer resources and a fundamental abuse of the trust we put in doctors. My office will hold accountable health care providers when they commit fraud for their own enrichment.”

The federal and state False Claims Acts mandate that the Governments recover triple the money falsely obtained, plus substantial penalties for each false claim submitted, and attorneys’ fees and costs to the whistleblower.  It should be noted that the civil claims resolved by settlement here are allegations only, and that there has been no judicial determination or admission of liability.  Dr. Saini and his practice deny these fraud allegations.

This matter was handled in partnership between the United States Attorney’s Office of the Eastern District of North Carolina and the Medicaid Investigations Division of the North Carolina Attorney General’s Office.  Assistant United States Attorney Neal Fowler and North Carolina Senior Deputy Attorney General Eddie Kirby represented the United States and State of North Carolina in this civil action.  The investigation was conducted by the HHS Office of Inspector General, including Special Agent Craig Schiffbauer, and the North Carolina Medicaid Investigations Division.