MESA, AZ (AZFamily) — A East Valley-based physician group has reached a multimillion-dollar settlement with the feds after allegations it billed public health programs for medically unnecessary procedures.
Tri-City Cardiology, based in Mesa with locations across Maricopa and Pinal counties, will pay $4.75 million to the United States and the state of Arizona as part of a civil settlement, the U.S. Department of Justice announced Thursday.
Prosecutors alleged three East Valley physicians, identified as Dr. Jaskamal Kahlon, Dr. Joshua D. Cohen, and Dr. M. Joshua Berkowitz, performed ablations on perforator veins between Jan. 1, 2017, and April 27, 2022, even though the veins did not qualify for treatment under accepted medical standards.
Perforator veins are small veins that connect deep and superficial leg veins and typically require treatment only in limited circumstances.
The doctors allegedly falsified medical records to make it look like the procedures were medically justified and met accepted standards before they were performed.
In a written statement, U.S. 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,” he said.
Tri City shared the following statement with Arizona’s Family about the settlement.
“Tri-City Cardiology has resolved a civil review with the U.S. Department of Justice concerning certain venous ablation procedures performed between 2016 and 2022.
We strongly disagree with the government’s allegations and unequivocally deny that our physicians knowingly submitted false claims or performed medically unnecessary procedures. The care at issue was provided under the 2020 Appropriate Use Criteria and the Medicare “reasonable and necessary” standard in effect at the time.
Over nearly three years, Tri-City fully cooperated with the inquiry and produced more than 150,000 pages of medical records and imaging. The matter ultimately centered on documentation and technical ultrasound reporting issues — not patient harm or clinical outcomes.
The settlement includes no contention of patient harm or patient complaints. Tri-City remains fully eligible to participate in Medicare and all federal health care programs, and this resolution does not impose ongoing federal monitoring or a Corporate Integrity Agreement.
We made the decision to resolve the matter to avoid prolonged litigation and remain focused on delivering high-quality cardiovascular and vascular care to our patients and the East Valley community.”
Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to HHS at 800-HHS-TIPS (800-447-8477).
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