Prosecuting Medical Fraud

I’ve been blogging a lot about overtreatment of patients with unnecessary tests that costs billions of dollars each year and countless numbers of lives lost. Just last week, I reported that as many as 50% of the 600,000 angioplasties performed last year were questionable or unnecessary!

Well, finally it seems that the government is cracking down on these unnecessary tests. As reported in yesterday’s Baltimore Sun, Salisbury, Maryland-based Peninsula Regional Medical Center has “agreed to pay $2.8 million to settle federal claims it failed to prevent cardiologist John R. McLean from placing medically unnecessary stents in dozens of patients between 2003 and 2006,” according to the Maryland US Attorney’s Office. McLean was “convicted last month in US District Court of healthcare fraud and related charges for falsifying patient records to make it appear they needed coronary stents, then billing private and public insurers hundreds of thousands of dollars for the unwarranted procedures.” He faces a “maximum of 35 years in prison at his sentencing, set for Nov. 10.” The hospital, which “admits no liability…has already repaid nearly $1 million”; and it has also agreed to “repay any federal funds it received for McLean’s improper stents,” federal prosecutors said.

Hopefully, once word of these prosecutions gets out, more cardiologists and hospitals will take notice. If Medicare would be more pro active and review procedures before they’re completed to deem whether they’re medically necessary more of them could be prevented. Elective angioplasties to assymptomatic patients has no place in medicine.


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