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TN Whistleblower Lawsuit Ensnares Radiologist

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Until recently, two cardiologists in Jackson, Tennessee, had squared off, with two hospitals and a radiologist drawn into the fray, over sensational but secret charges of fraudulent billing, kickbacks, illicit self-referrals, and deliberate overuse of medical services.

Earlier this month, a heavyweight joined the fight. The federal Department of Justice ended the secrecy by intervening on the side of the whistleblower—but only for part of the case. Here’s the story:

In 2007, Wood M. Deming, MD, a cardiologist at Regional Cardiology Consultants in Jackson, filed suit claiming that another cardiologist, Eli Hage Korban, MD, had submitted false claims to Medicare, TRICARE, and Medicaid. (Jackson is 90 miles northeast of Memphis in western Tennessee.)

The suit, filed under seal, said Dr. Korban had help in carrying out the fraud from James Moss, CEO of Jackson-Madison County General Hospital; Timothy Puthoff, CEO of Regional Hospital of Jackson; and Joel Perchik, MD, a radiologist.

According to HealthImaging.com, the suit charges that:

CEOs Moss and Puthoff, despite the advice and counsel of members of their respective hospitals’ medical staffs, chose to ignore blatant overutilization of cardiac medical services, including but not limited to cardiac sonography, scintigraphic stress imaging, angiography, angioplasty and stenting by Korban, shielding same from any scrutiny by the hospitals’ clinical quality improvement mechanisms.

The lawsuit says Dr. Korban ordered “numerous unnecessary diagnostic studies” on elderly nursing home patients, then ordered their transport by ambulance to the hospitals for additional unnecessary procedures. Many of the procedures involved imaging.

“Korban also followed the same scheme in some cases with patients who were very young, in many cases in their twenties, who were at little, if any risk for heart disease,” the lawsuit says. Though many of those patients received negative stress imaging test results, the suit says, the patients still underwent catheterization procedures.

The suit says the two hospital CEOs and Dr. Perchik “engaged in a pattern of bad-faith peer review of any physician who chose to oppose the hospitals’ drive for excess and inappropriately collected remuneration.”

This is a whistleblower suit. Under federal law, Dr. Deming will receive part of any fines or other money the government eventually gets from the defendantsl

Oddly, although the government intervention triggered the unsealing of the case, the government is—for now, at least—intervening only in the part of the case that deals with Dr. Korban.

“While the United States has intervened in a portion of the case as it relates to an independent physician who serves on the medical staffs of both hospitals,” said Regional Hospital spokesperson Lisa Ragsdale in a statement, “the government declined to intervene in the case as it relates to all other defendants. Regional Hospital of Jackson is pleased that the U.S. chose not to intervene in the portion of the relator’s lawsuit which named the hospital and a former administrator.”

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