Cardiology Clinic and Physician Pay $270,000 to Settle Allegations of Submitting False Claims to Medicare and TRICARE
Department of Justice, U.S. Attorney's Office, Oklahoma, Western. Published December 30, 2024.
Cardiovascular Specialists and Dr. Katz allegedly engaged in improper "incident-to" billing by submitting claims to Medicare for E&M services under Dr. Katz' NPI that were performed by nurse practitioners when he was not in the clinic supervising them, and submitted claims to Medicare and TRICARE for E&M services that should have been billed at a lower reimbursement level.
Providers named in this release
Matched to the national provider registry by name, place and provider type at high confidence only. Each opens the provider's own record.
NPI 1285727289no indicators in VerityNPI 1659452324no indicators in VerityOKLAHOMA CITY to Cardiovascular Specialists, Inc., (“Cardiovascular Specialists”) and Stewart Katz, MD (“Dr. Katz”), paid $270,000 to settle civil claims stemming from allegations that Cardiovascular Specialists and Dr. Katz submitted false claims to Medicare and TRICARE, announced U.S.
Attorney Robert J. Troester. Cardiovascular Specialists is an Oklahoma corporation which operated a cardiology clinic in Tulsa, Oklahoma, (“Clinic”).
Dr. Katz is a cardiologist who owned and practiced at the Clinic. The United States alleges that from January 1, 2016, through February 28, 2020, Cardiovascular Specialists and Dr.
Katz engaged in improper “incident-to” billing. Specifically, Cardiovascular Specialists and Dr. Katz submitted or caused the submission of claims to Medicare for the payment of evaluation and management (“E&M”) services under Dr.
Katz’ National Provider Identification number that were performed by nurse practitioners when Dr. Katz was not in the Clinic supervising them. The United States also alleges that from January 1, 2015, through June 16, 2022, Cardiovascular Specialists and Dr.
Katz submitted or caused the submission of claims to Medicare and TRICARE for E&M services that should have been billed at a lower reimbursement level. To resolve the claims, Cardiovascular Specialists and Dr. Katz agreed to pay $270,000 to the United States.
The settlement resolves allegations filed in a lawsuit by a whistleblower who formerly worked for Cardiovascular Specialists. The lawsuit was filed in federal district court in Oklahoma City under the qui tam , or whistleblower, provisions of the False Claims Act (the “Act”), which permit private individuals to sue on behalf of the United States for false claims and to share in the recovery. The Act also allows the United States to intervene in the lawsuit, which it did in this case.
The allegations raised in the lawsuit will be dismissed as part of the settlement. In reaching this settlement, Cardiovascular Specialists and Dr. Katz did not admit liability, and the United States did not make any concessions about the legitimacy of the claims.
The agreement allows the parties to avoid the delay, expense, inconvenience, and uncertainty involved in litigating the case. Investigative assistance was provided by the Defense Criminal Investigative Service and HHS-OIG Office of Audit Services. Assistant U.S.
Attorneys Ronald R. Gallegos and Amanda R. Johnson prosecuted the case.