A Kentucky cardiologist pressured and lied to patients—causing them unnecessary pain and medical risk—to perpetrate health care fraud. Dr. Anis Chalhoub was found guilty of implanting medically unnecessary pacemakers in his patients and fraudulently billing them and the follow-up care to Medicaid, Medicare and other health insurance programs.
Evidence showed that Chalhoub implanted dozens of unnecessary pacemakers, with government health care programs and private insurers suffering hundreds of thousands of dollars in losses. (Add to that, the patients and their families who suffered untold anxiety, pain, complications, and lost time thanks to unneeded and potentially harmful treatment.)
United States Attorney Robert M. Duncan, Jr. emphasized that “…the defendant violated his medical oath and placed greed over patient care… and needlessly put lives at risk.” Chalhoub was sentenced to 42 months in federal prison and must pay a $50,000 fine and $257,515 to Medicaid, Medicare and other private insurers.
Following his prison sentence for committing health care fraud, the Kentucky physician will be supervised by the U.S. Probation office for three years and prohibited from practicing cardiology during that time. Chalhoub’s attempt to have the health care fraud case retried was denied by the Sixth Circuit Court in January 2020. (Looks like the doctor will now have plenty of time to brush up on the Hippocratic oath.)
Today’s Fraud of the Day comes from a media release from the United States Attorney’s Office, Eastern District of Kentucky, “London Cardiologist Sentenced to 42 Months for Health Care Fraud,” published Oct. 31, 2018.
LONDON, Ky. – Yesterday, London physician Dr. Anis Chalhoub was sentenced, by U.S. District Court Judge Gregory F. Van Tatenhove, to serve 42 months in federal prison for health care fraud. In April 2018, a federal jury returned a guilty verdict, after hearing evidence that Dr. Chalhoub defrauded Medicare, Medicaid, and other insurers by implanting medically unnecessary pacemakers in his patients, and causing the unnecessary procedures and follow-up care to be billed to health insurance programs.
Between 2007 and 2011, Dr. Chalhoub implanted approximately 234 pacemakers in patients at St. Joseph London hospital. The evidence at trial showed that dozens of those patients’ pacemakers were medically unnecessary, under well-established national guidelines and Medicare coverage rules. A number of patients testified at trial that Dr. Chalhoub pressured them into getting the procedures and told them misleading information about their health conditions. For instance, several patients recalled Dr. Chalhoub telling them that they might die without a pacemaker. Sinus node dysfunction, the diagnosis Dr. Chalhoub gave the patients, is a non-fatal condition. The jury also heard evidence that Medicare, Medicaid, and other insurers suffered hundreds of thousands of dollars in losses from Dr. Chalhoub’s unnecessary procedures.
Additional information is available from a Mondaq article, No Valentine for “Very Busy” Cardiologist Convicted of Fraud, published Jan. 13, 2020.