An Indian-origin urologist, Jitesh Patel, will pay $14 million to settle allegations that he defrauded healthcare programs by carrying out procedures that patients did not actually need, according to the DOJ. The case centres around his clinic, Advance Urology in Georgia, and a pattern of unnecessary treatments and tests.
Indian-origin doctor to pay $14 million in US healthcare case
The issue first surfaced when an employee at Advance Urology filed a whistleblower complaint. The employee alleged that the clinic was routinely performing procedures and tests that were not medically necessary. Later, another former employee also came forward and backed the claims.
According to court documents, the clinic was “designed to maximise revenue for Dr Patel and others by performing medically unnecessary procedures and tests”.
Patel, on the other hand, is considered a respected name in urology and has received several recognitions, including “Atlanta Top Doctor” and “Top 40 Under 40”.
What the allegations say
It is alleged that devices were implanted in some patients without properly checking if they would actually benefit from them. Patients were also made to undergo unnecessary tests, some of which required them to be put under anaesthesia.
The clinic is also accused of ordering thousands of ultrasound tests that were not needed. In fact, every new patient was reportedly required to undergo one such test, even though it is not commonly used in regular urology practice. There were also claims that the clinic billed for procedures that were never performed at all.
Federal agencies step in
The case was investigated by multiple US agencies, including the US Attorney’s Office, the FBI and the Department of Health and Human Services. US Attorney Theodore S Hertzberg made it clear that such actions would not be taken lightly. “Physicians commit fraud when they seek payment for medically unnecessary procedures or bill for services they never performed,” he said. “Our office will not tolerate abuse of patients or misuse of government funds, and we will enforce the False Claims Act to hold wrongdoers accountable.”
The case falls under the False Claims Act, which allows private citizens to file lawsuits on behalf of the US government if they believe false claims are being made. Those who come forward, known as relators, are also entitled to a share of the recovered amount.
In this case, the whistleblowers will collectively receive $2,940,000 from the settlement. It is important to note that the settlement resolves allegations only. There has been no formal determination of liability. The lawsuits do not say whether these alleged unnecessary procedures caused any health problems for patients.