Once again, a critic who says he was reprimanded for confidentially raising concerns about doctors' pay has turned into a whistle-blower for the federal government.
This time it happened in Mobile, Ala., where cardiologist Dr. Christian Heesch says a profit-sharing arrangement between doctors and the diagnostic clinic owned by Infirmary Health System violated the Stark law and False Claims Act. Potential damages are said to be north of $500 million, making it at least the third active nine-figure Stark case pending against a hospital in which the U.S. Justice Department has intervened as a plaintiff.
Unlike some of the other cases, Heesch also pinpoints human victims: patients, including a few military families on Tricare, whom he claims were needlessly exposed to potentially harmful radiation through nuclear stress tests that use radioactive dye to measure the flow of blood through the heart. Most of the victims cited in the complaint were on Medicare and Medicaid.
Mark Nix, CEO of Infirmary Health System, said in an e-mailed statement that the allegations relate mainly to work done in Infirmary's Diagnostic and Medical Clinic, a subsidiary of Infirmary and codefendant. He said the clinic denies the allegations and will fight them vigorously.
Heesch said he began speaking out about his concerns at least four years before he filed suit, objecting to both the arrangements that gave physicians incentive to allegedly falsify medical records to justify more testing, as well as the high number of stress tests being done on patients.
In March 2009, Heesch made a confidential report to the Alabama Department of Public Health, which he said cited the system's Mobile Infirmary Medical Center with violations for improper imaging and ordering corrective actions.