The U.S. Attorney’s Office for the Northern District of Ohio announced that EMH Regional Medical Center (EMH), a non-profit community hospital system located in Lorain County, Ohio, and North Ohio Heart Center, Inc. (NOHC), an independent physician group that practiced at EMH, agreed to pay approximately $4.4 million to resolve allegations under the False Claims Act that EMH and NOHC performed unnecessary cardiac procedures between the years 2001 and 2006. EMH will pay will pay nearly all of the $4.4 million—$3,863,857—with NOHC paying the remaining $541,870. United States ex rel. Loughner v. EMH Regional Medical Center, et al., Case No. 1:06-cv-2441 (N.D. Ohio).
Kenny Loughner, the former manager of EMH’s catheterization and electrophysiology laboratory, initiated the matter by filing a qui tam or “whistleblower” complaint in 2006 (the Complaint). According to the Complaint, NOHC cardiologists performed unnecessary, excessive and/or improper medical procedures—namely angioplasties—at EMH’s facility, thereby providing pecuniary benefit to EMH since it provided the facilities for the allegedly over-prescribed procedures. Among other allegations, Loughner claimed that NOHC’s cardiologists maintained a practice of performing an angiogram procedure without being prepared to immediately perform an angioplasty if shown to be necessary from the angiogram, contrary to the standard of care. Instead, according to Loughner, the cardiologists would perform the angiogram, and then schedule the patient for a subsequent angioplasty procedure, which effectively “unbundled” the procedures. In addition, for patients requiring multiple stents, Loughner claimed that the cardiologists would insert fewer than necessary stents during one procedure, which allowed the cardiologists to schedule “serial angioplasties.” Loughner will receive $660,859 as a result of the settlement.
The U.S. Attorney’s Office for the Northern District of Ohio, the Justice Departments’ Civil Division, the HHS OIG, and the Federal Bureau of Investigation jointly handled the investigation.
Reporter, Kerrie S. Howze, Atlanta, +1 404 572 3594, khowze@kslaw.com.
