HOUSTON – Advanced Cardiovascular Care Center P.A. and its owner and administrator have agreed to pay $400,000 to resolve allegations they violated the False Claims Act (FCA), announced U.S. Attorney Ryan K. Patrick.
Owner Dr. Annie T. Varughese, 57, and administrator Babu Varughese, 64, both of Spring, conducted business in three clinics located in Houston, Conroe and The Woodlands.
From June 4, 2013, through June 4, 2016, the company submitted claims to Medicare for cardiology services. These included cardiac external counterpulsation treatments, transthoracic echocardiography studies and duplex scans that were not reasonable and medically necessary. Therefore, they failed to meet the Medicare coverage and documentation requirements.
Further, patient files lacked documentation that Varughese directly supervised the cardiology services as Medicare requires. The company billed Medicare for services under Varughese’s provider number when she was not in the office and, at times, not even in the United States.
“Putting financial gain ahead of medical necessity undermines the integrity of the Medicare program,” said Special Agent in Charge Miranda Bennett of the Department of Health and Human Services – Office of Inspector General (DHHS-OIG). “We will continue investigate and hold accountable those who submit false claims to federal health care programs.”
“The largest area of fraud committed against the federal government today is by unethical healthcare providers who inflate or fabricate Medicare or Medicaid bills,” said Special Agent in Charge Perrye K. Turner of the FBI. “Billing Medicare for services that are not necessary and/or not provided constitutes fraud. American taxpayers are the ones who ultimately bear the financial burden created by this, as healthcare fraud translates into higher premiums and out-of-pocket expenses for consumers. We ask for the public's help in reporting and exposing dishonest healthcare providers."
The investigation began in 2016 after a former cardiologist filed a sealed lawsuit under the qui tam provisions of the FCA. It allows private citizens with knowledge of fraud to bring a lawsuit on behalf of the United States. They may be entitled to a share of the proceeds of the action or any settlement.
DHHS-OIG and FBI conducted the investigation. Assistant U.S. Attorney Julie Redlinger handled the matter.
The claims resolved by this agreement are allegations only, and there has been no determination of liability.
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| Component | USAO - Texas, Southern; |
| OIG | Department of Health and Human Services OIG |