WASHINGTON - The United States has intervened in a False Claims Act lawsuit alleging that Satilla Health Services Inc., dba Satilla Regional Medical Center, and Dr. Najam Azmat submitted claims for medically substandard and unnecessary services to Medicare and Medicaid, the Justice Department announced today. Specifically, the complaint alleges, among other things, that the defendants submitted claims for medical procedures performed by Dr. Azmat in Satilla’s Heart Center that the physician was neither qualified nor properly credentialed to perform. As a result, at least one patient died and others were seriously injured.
The complaint states that Satilla placed Dr. Azmat on staff even after learning that the hospital where he previously worked had restricted his privileges as a result of a high complication rate on his surgical procedures. The complaint also states that after Dr. Azmat joined the Satilla staff, the hospital management allowed him to perform endovascular procedures in the hospital’s Heart Center even though he lacked experience in performing such procedures and did not have privileges to perform them. Endovascular procedures are complex medical procedures that are performed within arteries and veins accessed by a puncture site in the skin and require specialized training.
According to the complaint, at least one of Dr. Azmat's endovascular patients died as a result of his lack of training and competence. The complaint alleges that Dr. Azmat perforated the patient's renal artery, causing her to bleed to death. Dr. Azmat allegedly did not even recognize that he had perforated the patient’s artery and failed to take appropriate action to address the complication.
The complaint further states that the nurses in Satilla’s Heart Center recognized that Dr. Azmat was incompetent to perform endovascular procedures and repeatedly raised concerns with hospital management. Despite the nurse’s complaints and Dr. Azmat’s high complication rate, Satilla’s management continued to allow him to perform endovascular procedures and to bill federal health care programs for these services.
"In this case, the defendants allegedly not only provided substandard and unnecessary medical services - they caused harm to patients," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "We are committed to bringing to justice those who put profits ahead of patient health and safety."
This lawsuit was originally filed by Lana Rogers, a nurse who formerly worked in Satilla’s Heart Center. Under the qui tam, or whistleblower, provisions of the False Claims Act, a private citizen can file an action on behalf of the United States and receive a portion of any recovery. The act permits the United States to recover three times the amount of its losses, plus civil penalties.
"The fraud alleged in this case not only caused financial loss to the government, but sadly also endangered the lives of federal health care program beneficiaries," said U.S. Attorney Edward Tarver.
The investigation in this case is being conducted by the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Southern District of Georgia, and the Office of Inspector General of the Department of Health and Human Services.
The United States’ intervention is part of the government’s emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover approximately $2.3 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 have topped $3 billion.