Consumer Fraud

U.S. indicts Auburn cardiologist on 10 counts of health care fraud

cardiologist fraud 435x245 U.S. indicts Auburn cardiologist on 10 counts of health care fraudThe U.S. government indicted an Auburn cardiologist May 21, accusing him of implanting patients with heart stents they didn’t need so that he could bill federal and private insurance programs for his own financial gain.

According to the indictment, Dr. Robert W. Mitchell allegedly performed unnecessary heart catheterizations from at least January 2006 to February 2012, falsely documenting the extent of coronary blockages in his patients and their need for the stent procedures.

The federal government alleges that Dr. Mitchell then submitted false claims to Medicare, Medicaid, and private insurance companies for reimbursement, a practice that increased the profit margin for his private practice at The Heart Center Cardiology in Auburn, also known as the Institute for Advanced Cardiovascular Care. Dr. Mitchell also had hospital privileges at East Alabama Medical Center in Opelika.

“A coronary stent was not considered medically necessary absent a diagnosis of at least a 70 percent blockage,” said U.S. Attorney George L. Beck in a statement. “In an apparent attempt to increase his profit, Dr. Mitchell is alleged to have implanted stents in patients who did not have a 70 percent or more blockage in their arteries while falsely recording otherwise in their medical records.”

If convicted, Dr. Mitchell faces a maximum 10-year prison sentence on each of two counts of health care fraud and five years in prison on each of eight counts of making false statements related to health care matters.

The indictment lists 10 patients who the U.S. alleges were targeted by Dr. Mitchell’s scheme. The indictment also describes how patients who receive unnecessary stents often require additional stent procedures in the future and are put at higher risk for additional and adverse medical conditions.

According to the U.S. Attorney’s office, the 10-count indictment also seeks a $450,000 penalty from Dr. Mitchell for the alleged fraud.

Dr. Mitchell retains his medical license pending the results of an investigation by the Alabama Board of Medical Examiners and Medical Licensure Commission.

“The charges that the government has brought against me are false,” Dr. Mitchell said in a statement. “I look forward to my day in court and the opportunity to clear my name.”

Sources:

Opelika-Auburn News
AL.com