Dr. Devender Batra and Belmont Cardiology Inc. of St. Clairsville will pay a $1 million penalty for violations involving fraudulent Medicare claims.
U.S. Attorney William J. Ihlenfeld II said Batra and Belmont Cardiology will pay the fine after causing East Ohio Regional Hospital and Ohio Valley Medical Center to submit fraudulent claims to Medicare from January 2009 to August of 2010, in violation of the Federal False Claims Act.
The settlement ends an investigation into improper compensation arrangements between Batra, East Ohio Regional Hospital and Ohio Valley Medical Center. The arrangements with Batra and Belmont Cardiology led the hospitals to submit false claims for prohibited referrals for various health services in violation of Federal law.
"These types of prohibited referrals are a significant problem and led to increased health care costs for everyone," Ihlenfeld said. "Medicare expects that a physician's referral of a patient to a hospital will be free from improper influences, and when it's not we will act to hold the wrongdoers accountable."
The investigation arose after the U.S. Attorney's Office resolved claims against East Ohio Regional Hospital and Ohio Valley Medical Center for entering into improper compensation arrangements with Batra and others.
In September 2011, the court ordered Ohio Valley Health Services and Education Corp, the parent company of EORH and OVMC, to pay $3.8 million in federal fines for making false Medicare and Medicaid claims.
"This is a follow up to an ongoing investigation that began after the Board of Trustees for East Ohio Regional Hospital and Ohio Valley Medical Centers identified issues and promptly notified the U.S. Attorney," said Michael Caruso, president and CEO of OVHS&E. "We fully cooperated with the U.S. Attorney's Office and resolved the hospital's issues in September of 2011."
Ihlenfeld said OVHS&E made no official admission of liability but agreed to pay the fines for violating the Stark Act.
"Referrals of patients that are motivated, to any degree, by prohibited compensation arrangements may lead to costly and unnecessary medical care. For this reason we encourage anyone who has knowledge of such arrangements between a medical facility and a physician to report it," Ihlenfeld said.
"Sound medical decision-making cannot be influenced by financial gain," said Nick DiGiulio, special agent in charge for the Inspector General's Office of the U.S. Department of Health and Human Services in Philadelphia. "We are pleased that these allegations are resolved and will continue to work with the Department of Justice to root out illegal, wasteful business arrangements."
The False Claims Act is a federal law that allows the government to sue health care providers who submit false or fraudulent claims to federal health care programs, such as Medicare, or cause others to do so. False claims submitted by medical providers cost federal health care programs billions of dollars each year.
Assistant U.S. Attorney Alan G. McGonigal, in coordination with the U.S. Department of Health and Human Services, Office of Inspector General, handled this case.
Batra, a physician who practices cardiology in Belmont County and the surrounding area, is the president of Belmont Cardiology Inc., a medical corporation located at 157 E Lawn Ave., St. Clairsville. He did not respond to a request for a comment.