Hospital chain HCA has agreed to pay $2 million to settle allegations that doctors at one of its hospitals in Georgia performed unnecessary, low-quality heart procedures.
Whistle-blower Dr. Michael Fenster first filed the False Claims Act case in 2010, but it wasn't made public until last week. Fenster, who was the executive director of the cardiovascular program at HCA's Fairview Park Hospital in Dublin, Ga., alleged that two Fairview doctors performed medically unnecessary procedures, leading to patient harm and death.
Fairview said in a statement Tuesday, “We are pleased to have reached an agreement to resolve this with no admission of wrongdoing, and we remain focused on providing the best patient care, as recognized by the Leapfrog Group, which recently scored Fairview Park with an ‘A’ for patient safety for the third year in a row.”
Fenster had alleged the Fairview doctors misled patients about the seriousness of their conditions to get their consent to perform procedures such as angioplasty and stent placement. He also alleged that one of those doctors harmed patients by performing procedures for which he wasn't trained.
The hospital and HCA knew about these issues, and concealed records related to them, Fenster alleged. One of the doctors had been investigated before Fenster started working at the hospital, according to the complaint, and Fenster says HCA officials rejected his requests for greater supervision of that doctor.
The settlement comes several years after questions arose about the cardiology programs at some HCA hospitals.
In 2012, HCA disclosed that reviews had been conducted at a number of its hospitals on the medical necessity of their interventional cardiology services, and that the U.S. attorney's office in Miami wanted information related to those reviews. The New York Times ran an in-depth article at the same time on the issue at HCA.
Fairview was one of the hospitals that HCA looked at in that review, said Colette Matzzie, a partner with the whistle-blower law firm Phillips & Cohen who represents Fenster. In an October filing with the Securities and Exchange Commission, HCA reiterated that it had shared medical records associated with eight of those reviews with the U.S. attorney's office in Miami. HCA said in the filing that it was continuing its evaluation of the medical necessity of certain cardiology services at some HCA hospitals.
Two other lawsuits filed against HCA over the issue were dropped.
The government declined to intervene in Fenster's case, but he moved forward with it anyway. In False Claims Act cases, individuals can file lawsuits on behalf of the government, and the government can then choose whether to get involved. Cases that win the backing of the U.S. Justice Department tend to be more successful.
In successful False Claims Act cases, whistle-blowers are entitled to a percentage of the money recovered. Fenster will receive $560,000.
HCA, which is based in Nashville, Tenn., had operating revenue of $36 billion last year, according to the Modern Healthcare financial database.
