Jitesh Patel, an Atlanta, Georgia-based Indian American urologist and his practice Advanced Urology, will pay $14 million to settle a False Claims Act case involving allegations of fraudulent billing and unnecessary medical procedures.
Investigation began after a former employee filed a whistleblower complaint alleging that Advanced Urology performed unnecessary procedures, according to a press release from U.S. Attorney’s Office, Northern District of Georgia.
A second whistleblower complaint alleged that the practice billed government healthcare programs for procedures and tests that were not performed or were medically unnecessary.
The whistleblowers alleged, among other things, that Advanced Urology’s organization was designed to maximize revenue for Patel and others by performing medically unnecessary procedures and tests.
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The whistleblowers also alleged that Advanced Urology billed for a procedure known as Direct Visual Internal Urethrotomy (“DVIU”) that it never performed.
The DVIU procedure involves using a scope to dilate a patient’s urethra and a knife to cut tissue inside the urethra. Allegedly, Advanced Urology performed a less complicated dilation of the urethra but billed government healthcare programs for DVIU to obtain more payment than it was owed.
The whistleblowers alleged that Advanced Urology and Patel’s conduct resulted in the submission of false claims to federal healthcare programs, including Medicare and Medicaid.
Under the False Claims Act, private citizens may bring suit for false claims on behalf of the United States and share in any recovery obtained by the government. The whistleblowers will collectively receive $2,940,000 from the settlement.
“Physicians commit fraud when they seek payment for medically unnecessary procedures or bill for services they never performed,” said U.S. Attorney Theodore S. Hertzberg. “Our office will not tolerate abuse of patients or misuse of government funds, and we will enforce the False Claims Act to hold wrongdoers accountable.”
“This action underscores our commitment to safeguarding federal health care programs from fraud and abuse,” said Special Agent in Charge Kelly Blackmon of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).