Tri-City Cardiology, P.C., a physician group in the Phoenix area, and three of its physicians have agreed to pay $4.75 million to resolve allegations that they violated the False Claims Act by performing medically unnecessary vein ablations, according to a March 12 announcement from federal authorities.
The case is significant because it addresses concerns about healthcare providers billing federal programs for procedures that may not be needed, which can reduce resources available for necessary care. The settlement aims to protect taxpayer funds and uphold standards in medical practice.
Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division said, “Physicians should not prioritize profit over patient needs. Medicare and other federal programs pay only for medical care that meets accepted standards, and the falsification of medical records undermines efforts to assess whether medical care was appropriate.”
United States Attorney for the District of Arizona Timothy Courchaine said, “Paying for unnecessary medical procedures reduces federal programs’ capacity to pay for truly necessary procedures. When medical providers do not respect the difference between the two and bill in the interest of their own bottom line instead of their patients, the United States Attorney’s Office has pursued and will continue to pursue appropriate recoveries to protect taxpayer funds.”
Federal officials allege that from January 1, 2017, through April 27, 2022, Dr. Jaskamal Kahlon, Dr. Joshua D. Cohen, and Dr. M. Joshua Berkowitz knowingly performed ablations on perforator veins that did not meet accepted standards for treatment. Authorities contend that Tri-City Cardiology and these physicians knowingly misrepresented or incorrectly documented key clinical details in patient records so that treatments appeared justified under accepted guidelines.
The investigation involved cooperation between the Justice Department’s Civil Division, Commercial Litigation Branch Fraud Section, the United States Attorney’s Office for Arizona, and assistance from HHS-OIG. Officials emphasized that combating healthcare fraud remains a priority and encouraged tips about potential fraud or abuse through HHS at 800-HHS-TIPS (800-447-8477).
Authorities clarified that all claims resolved by this settlement are allegations only; there has been no determination of liability.
