June 10, 2013

Heart doctor pleads to fraud

First Kentucky case for unnecessary procedures

By Nita Johnson
Staff Writer

LAUREL COUNTY, Ky. — The saga of lawsuits against a cardiology group reached a new mark with the guilty plea of one former London heart doctor.

In the first case of its kind in Kentucky history, former London cardiologist 51-year-old Sandesh Rajaram Patil plead guilty to health care fraud stemming from procedures performed during 2009 and 2010.

In the guilty plea, entered in a Frankfort federal court on Tuesday, Patil admitted that he falsified records on patients’ conditions and inserted stents when the blockages in the arteries did not meet the minimum standards for Medicaid and Medicare requirements.

Stents are metal tubes inserted through surgical procedures into patients’ arteries to improve blood flow. Medicaid and Medicare standards require that blockages be at least 70 percent. In the guilty plea, Patil admitted recording the blockages at 70 percent in order to collect payment from Medicare and Medicaid. Patil has been named in several lawsuits filed against the cardiology group in London and was a former cardiologist in London who performed surgeries at Saint Joseph London. The claims of unnecessary procedures being done on cardiology patients came to light in September 2011 and resulted in over 400 persons being named in lawsuits with 11 physicians named as defendants. Hospital officials said that nearly one-fourth of those cases have been dismissed, however.

Patil could receive up to three years in prison for his deeds, and is set for sentencing on August 27.

He is the third cardiologist in the nation and the first in Kentucky to be prosecuted on the federal level for health care fraud related to unnecessarily placing heart stents.

“Dr. Patil violated the public’s trust in physicians,” said Kerry B. Harvey, U.S. Attorney for the Eastern District of Kentucky. “Both patients and the entities that pay for medical services trust that our physicians will accurately and honestly assess a patient’s medical condition. We will aggressively pursue any physician or provider that breaches this trust and places their own financial well-being ahead of the well-being of the patients.”

Although Patil performed procedures at Saint Joseph London, hospital officials state that Patil was never an employee of the hospital. A statement released on Wednesday from Sharon Hershberger with the London hospital’s public relations department said:

“Saint Joseph London hospital has cooperated with the U.S. Attorney’s office throughout the investigation. Dr. Patil was not an employed physician, has not had privileges at the London hospital since December 2010 and has not practiced there since.”

 Patil’s medical license was restricted by the Kentucky Board of Medical Licensure in March in an agreement in which Patil was required to attend classes regarding documentation procedures. He was also restricted to have a second opinion by a licensed physician before performing any procedures.

Physicians are considered “private practitioners” but are given privileges to do procedures at hospitals. Patil was previously employed at Hazard’s Appalachian Heart Center after leaving the London cardiology group.