Kentucky-based cardiologist Dr. Sandesh Rajaram Patil, 51, admitted this week that he lied about a patient’s heart health in order to justify implanting a stent and submitting a claim for federal reimbursement. Patil is the 3rd cardiologist nationwide and the 1st from Kentucky to face federal prosecution for unnecessary cardiac stenting.
The Centers for Medicare & Medicaid reimburse physicians for cardiac stenting procedures only when they qualify as a "medical necessity," defined as an artery blockage of at least 70% accompanied by symptoms of blockage.
Patil admitted that he lied and reported 70% blockage in arteries that had "substantially less than 70% blockage," according to a report from the U.S. Attorney’s Office.
"Dr. Patil violated the public’s trust in physicians," Kerry Harvey, U.S. Attorney for the Eastern District of Kentucky, said in prepared remarks. "Both patients and the entities that pay for medical services trust that our physicians will accurately and honestly assess a patient’s medical condition. We will aggressively pursue any physician or provider that breaches this trust and places their own financial well-being ahead of the well-being of the patients."
Patil faces between 30 and 37 months in prison for healthcare fraud. The St. Joseph’s Hospitals in London, Ky., has already repaid more than $250,000 for procedures Patil falsely submitted in 2009 and 2010, according to the report.
A handful of other doctors have come under fire for unnecessary stenting procedures, among them Maryland’s Dr. Mark Midei, who was accused of implanting stents in hundreds of patients who didn’t need them, and Pennsylvania’s Dr. Vidya Banka, who resigned his position amid an over-stenting investigation.