Compliance News Roundup: Doctors Blowing the Whistle on Other Doctors

1. Houston doctor is eighth person convicted in $13 million healthcare fraud case: A Houston physician was convicted in federal court Wednesday for his role in a $13 million fraudulent Medicare billing scheme involving hundreds of patients-for-hire. Eight co-defendants - including the clinic director - had previously admitted to helping bill for unnecessary tests for the patients who were recruited and delivered to the clinic by marketers, according to participants' sworn testimony. After hearing six days of evidence and arguments in the case, a federal jury convicted Dr. Faiz Ahmed, 64, of ordering hundreds of unnecessary EKGs and breathing tests as part of a conspiracy to defraud the government. Read more here: http://www.chron.com/news/houston-texas/article/Houston-doctor-is-eighth-person-convicted-in-13-10883174.php

2. Miami cardiologist acquitted in $57 million Medicare fraud case: A Miami-Dade cardiologist has been acquitted of receiving thousands of dollars in kickbacks as part of a $57 million Medicare fraud scheme. Dr. Michael Bahrami, 61, who practices in the Aventura area, was found not guilty Wednesday by a Miami federal jury on a single conspiracy charge of defrauding the government. He had faced up to five years in prison in a case that threatened to end his medical career. Read more here: http://www.miamiherald.com/news/local/article127433574.html

3. Deeper Than The Headlines: Doctors Blowing the Whistle on other Doctors - In this edition of Deeper Than The Headlines, I’ll dive deep into a few case studies where doctors blew the whistle on their peers. On December of 2016, the U.S. Attorney’s Office for the Southern District of Florida announced a $12 million settlement with South Miami Hospital regarding allegations of medically unnecessary cardiac electrophysiology studies and other procedures allegedly performed by John R. Dylewski, M.D. It’s especially interesting that the whistleblowers in the case against the hospital and Dr. Dylewski were themselves doctors who claimed they raised concerns about medically unnecessary cardiology procedures with hospital executives including the CEO. They say these complaints fell on deaf ears because Dr. Dylewski was producing a high volume of procedures resulting in significant reimbursement from payors such as Medicare. Read more here: Deeper Than the Headlines: Doctors Blowing the Whistle on Other Doctors