Elyria OH Hospital and Doctor Group Settled ‘Overtreated’ Medicare Patient Allegations by DOJ

Physicians from the North Ohio Heart Center, Inc (NOHC) and the EMH Regional Medical Center (EMH) have settled allegations made by federal regulators that they ‘overtreated’ Medicare patients by performing unnecessary angioplasty cardiac procedures from 2001 to 2006.

Angioplasties are performed to treat blocked coronary arteries and often involve the placement of a stent to keep the vessels open. According to a 2006 article by the New York Times, a Dartmouth Medical School researcher found that Medicare data showed that patients in Elyria, Ohio, which is served by the NOHC and EMH, allegedly received angioplasty at a rate of 42 per 1,000 when the national average at the time was only 11.3 per 1,000. {NYT August 2006 article: https://www.nytimes.com/2006/08/18/business/18stent.html?pagewanted=all&_r=0}

Also in 2006, a former manager of the catheterization laboratory at EMH filed a whistleblower lawsuit under the False Claims Act (FCA) that alleged that physicians pressed staff to falsify complaints made by cardiac patients, and raised questions about patients receiving multiple procedures leading to the ‘overtreated’ Medicare patients allegations.

After reaching the agreement, the NOHC posted a statement to its website that said the group “passed every Medicare audit ever done”, and “we felt confident we were making the correct choices for our patients. We still do.” The NY Times reports that EMH released a statement saying that “there is no question that the patients treated had heart disease and some degree of blockage.”

No specific physicians were singled out by federal regulators during the investigations, nor were any disciplined due to the accusations, according to the NYTimes. NOHC said in their statement that though a settlement was reached, it was without “an admission of wrongdoing”. The group said they “settled this matter so we can put it behind us and move forward.”

According to the settlement, EMH Regional Medical Center will pay $3.9 million, the North Ohio Heart Center will pay $541,870, and out of this total, the whistleblower will receive $660,859 for his role.