Skip to main content

MD Hospital to Settle Cardiac Stents Fraud Case for $1.8M

 |  By John Commins  
   August 12, 2011

Peninsula Regional Medical Center will pay the federal government $1.8 million to settle claims that officials at the Salisbury, MD hospital knew about, but failed to act on, unnecessary cardiac stent procedures performed by a cardiologist, the Department of Justice has announced.

The cardiologist, John R. McLean, MD, was convicted of fraud last month after federal prosecutors showed that he inserted unnecessary cardiac stents into more than 100 patients as part of a scheme to defraud government and private insurers of more than $700,000.

The settlement this week with PRMC resolves allegations that senior medical staff at PRMC failed to act on complaints of staff in the cardiac catheterization laboratory about the medically unnecessary procedures that McLean was performing, DOJ said in a media release.

PRMC also agreed to repay money it received from federal health benefit programs between April 24, 2003 and Dec. 4, 2006 for medically unnecessary stents performed by McLean.


The hospital entered into a Corporate Integrity Agreement with the Department of Health and Human Services, Office of Inspector General, which requires PRMC to ensure accurate billing. The CIA also requires the hospital to appoint physician executives to oversee medical staff quality-of-care matters, DOJ said.

McLean, 59, could receive up to 35 years in prison when he is sentenced on November 10. Prosecutors want to recover $711,583 that they believe McLean garnered in the scheme, but U.S. District Judge William D. Quarles, Jr. will determine the exact amount of forfeiture at the sentencing.

Evidence presented at the two-week trial showed that from at least 2003 to May 2007 McLean performed cardiac catheterizations and implanted unnecessary cardiac stents in more than 100 patients at the hospital, prosecutors said.

McLean, federal prosecutors added, falsely recorded in the patients' medical records the existence or extent of coronary artery blockage to justify the stents and the claims to health insurers, including Medicare and Medicaid.

In a statement released Wednesday, PRMC said: "Although Dr. McLean was convicted in  federal court in July of criminal charges, Peninsula Regional Medical Center has never been the focus of any criminal investigation or faced any criminal action related to his stenting practices."

PRMC referred to McLean as an "independent medical practitioner who "resigned his medical privileges in March 2007, shortly after questions arose about his stenting practices."

 

See Also:
DOJ Intervenes in TN Stent Fraud Lawsuit

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

Tagged Under:


Get the latest on healthcare leadership in your inbox.