[Ed. Note – This post is now in two parts. After writing this story, the court issued an extensive ruling which can now be found in part two.]
Part I. Dr. Asad Qamar and his cardiovascular practice, the Institute of Cardiovascular Excellence PLLC, filed for bankruptcy protection this week. The bankruptcy comes on the heels of a failed attempt to settle two whistleblower lawsuits alleging Medicare fraud. Dr. Qamar claims that the bankruptcy will stay the fraud charges. Federal prosecutors have joined with the two whistleblowers, however, and say the fraud case should proceed.
In our opinion, Qamar is either trying to buy time or hide his assets.
First Whistleblower Case Begins in 2011
The case against Dr. Qamar began in July of 2011 when an another physician filed a whistleblower complaint under the federal False Claims Act. Dr. Robert Green contended that Qamar engaged in “egregious acts of Medicare and Medicaid fraud through the performance of medically unnecessary, highly invasive, and therefore particularly dangerous heart procedures…” These procedures included cardiac catheterizations, peripheral vascular catheterizations and invasive aortic procedures.
Why would a physician do such a thing? Dr. Green and the U.S. Department of Justice say Qamar was doing it for the money. (Another whistleblower, Holly Taylor, would file a second whistleblower lawsuit in 2014 adding new Medicare fraud allegations.)
Court records indicate that many of Dr. Qamar’s patients were seen for Peripheral Artery Disease or “PAD.” PAD is usually caused by the build up of plaque and cholesterol on the inner walls of arteries. There are many ways to test for artery disease, most of them non-invasive. Only when a serious problem is detected do cardiologists resort to invasive testing.
If testing reveals that the patient needs revascularization, catheterizations are the normal next step. These can involve inserting a balloon into the artery to increase blood flow, placement of a stent or even catheterizations involving lasers to blast away plaque deposits.
All catheterizations involve risk. Although the procedure has been performed millions of times, complications remain common. Sometimes the catheter ruptures the artery causing internal bleeding, sometimes scar tissue forms causing the artery to again close up. Dislodged plaque can travel to the brain and cause a stroke. And always there is an increased risk of infection.
Medicare and Medicaid pay for PAD treatments but only if medically necessary. Prosecutors and Dr. Green say that in many cases, Dr. Qamar was operating solely for the sake of squeezing extra money from Medicare. In other words, he was putting profits before patients.
Qamar became so greedy that he began overbooking patients. Sometimes he would schedule 7 patients in an hour. An internal memo said employees should “OVERBOOK THE SCHEDULE.” The manager of Qamar’s Ocala, Florida facility wrote in an email that the overbooking and double bookings were leading to “mistakes” and “breakdowns” in patient care.
Qamar Accused of Unnecessary Surgeries
We have no doubt that some of the procedures performed by Qamar were justified. Even if justified, however, Qamar was so-overbooked that sometimes he would perform procedures or see patients until midnight. The sheer number of patients seen by Qamar strongly suggest the quality of care must have suffered.
Prosecutors Join the Whistleblower Complaints
In April 2015, prosecutors joined the fray. They claimed that committed Medicare fraud in a variety of ways including unnecessary stent procedures. According to their complaint, “When tests revealed stenosis in patients’ arteries, [Qamar] overestimated the severity of the blockage to justify lucrative interventions, including angioplasty, atherectomy, and stent implantation.” That suggests that non-evasive options weren’t explored. In other words, some patients were forced to needlessly suffer simply so Qamar could line his pockets.
It isn’t just prosecutors and Dr. Green who felt this way. The director of Dr. Qamar’s cath lab wrote in an email that Dr. Qamar “will do and say what ‘he’ likes and wants to do . . . sometimes without, what some would consider, any ‘real’ diagnosis or medical necessity!!!”
One patient told prosecutors that he left after having eight stents in a short period of time. For almost a year the patient, only identified as “C.F.”, would undergo an evasive procedure every month. Only after he found a new cardiologist did he learn that none of the stents were necessary. Worse, because C.F. suffers from a preexisting kidney disease, stenting for him became quite dangerous.
It doesn’t appear that Dr. Qamar cared. Qamar was able to bill Medicare for approximately $35,000 just for this single patient.
C.F. was one of the lucky patients that suffered no long term harm caused by bad or unnecessary care. Other patients were not so lucky.
Unnecessary Surgical Procedures = Medicare Fraud
Every physician that signs up for Medicare Part B signs a form that says,
I agree to abide by the Medicare laws, regulations and program instructions . . . . I understand that payment of a claim by Medicare is conditioned upon the claim and the underlying transaction complying with such laws, regulations, and program instructions (including, but not limited to, the Federal anti-kickback statute and the Stark law), and on the supplier’s compliance with all applicable conditions of participation in Medicare.
I will not knowingly present or cause to be presented a false or fraudulent claim for payment by Medicare, and I will not submit claims with deliberate ignorance or reckless disregard of their truth or falsity.
When a doctor bills Medicare, he or she certifies that the tests or procedures were medically necessary and properly performed. While everyone makes mistakes, court records suggest that Qamar had plenty of warnings from his own staff and outside auditors that there were aware of problems with his practice. As early as 2009, Qamar was being questioned and challenged on his Medicare billings.
Qamar Tries to Dodge the Medicare Fraud Claims
Shortly after the government joined in the whistleblower complaints, Dr. Qamar asked the court to dismiss the claims. Among his arguments, Qamar told the court that the complaints did not allege facts to support all the claims.
His bid to dismiss failed. In November of 2015, U.S. District Court Judge Roy Dalton ruled that the whistleblower complaints could proceed. In ruling in the government’s favor, Judge Dalton noted that according to the government, Dr. Qamar is the highest paid cardiologist in the country. In just two years he racked up over $35 million in Medicare reimbursements.
Judge Dalton said that the government did not need to name every patient and every false bill submitted to Medicare. (To do would have made the complaint thousands of pages long.) Rather, the government provided specific examples and said these were part of a “pattern and practice” of Medicare fraud.
Qamar Seeks Bankruptcy Protection to Avoid Whistleblower Claims
Failing to get the complaint dismissed, Qamar filed a petition seeking bankruptcy court relief last week. His lawyers claim that will stop the whistleblower claims from proceeding. He is wrong.
At most, Qamar may buy a few weeks of time but ultimately any judgment for Medicare fraud will not be dischargeable in bankruptcy. If a civil jury later determines that he intentionally harmed some of his patients, those claims will likely not be dischargeable either. Ditto if the Justice Department decides to seek an indictment and prosecute him criminally.
We understand that there are always two sides to every story. Qamar has long maintained his innocence. In July of 2015 he released a YouTube video calling the allegations against him a fiction. A group of apparent patients “disgusted and distressed” by “inaccurate” portrayals of “this extraordinary physician” created a Political Action Committee and took out a full page ad in the Ocala Star-Banner defending Qamar.
We believe the evidence against Qamar appears solid, however. Instead of trying to buy time, Qamar should be trying to seek forgiveness and pay back Medicare the tens of millions he has already collected. Is he guilty of Medicare fraud? We will likely soon find out.
Whistleblower Awards under the False Claims Act
The two Medicare fraud whistleblower cases against Dr. Qamar were filed under the federal False Claims Act. That law pays whistleblowers who come forward with inside information against wrongdoers believed to have cheated taxpayers. Since Medicare is funded with tax dollars, Medicare fraud can typically be prosecuted under the Act. (Florida has a similar law that pays awards for state Medicaid fraud violations.)
Awards under the False Claims Act range between 15% and 30% of whatever the government collects from the wrongdoer. If the government intervenes and takes over the case – like they did here in April of 2015 – the awards are usually at the lower end of the scale. When the whistleblower’s own lawyer takes the case through trial or settlement, however, the awards range between 25% and 30%.
To claim an award, a whistleblower needs inside information of the fraud, needs a lawyer and should be the first to file. Multiple whistleblowers can split an award if each has different inside information, however. This appears to be the case with Dr. Qamar.
False Claims Act cases also have a public disclosure bar meaning once the inside information becomes public knowledge, it is much more difficult to collect an award. If you are thinking about becoming a whistleblower and seeking an award, don’t speak with reporters or friends!
MahanyLaw – Medicare Fraud Whistleblower Lawyers
The whistleblower lawyers at MahanyLaw have already collected over $100 million in awards on behalf of their clients. The awards are real. Whistleblowers are also heroes that help recover billions of dollars each year for taxpayers. In Medicare fraud cases, they may even save lives.
If you are interested in collecting an award while also stopping fraud and greed, call us. Cases are handled on a contingent or success fee basis meaning you are not obligated for any costs or legal fees unless we recover money for you. All inquiries are also protected by the attorney – client privilege and kept confidential.
For more information, contact attorney Brian Mahany at or by telephone at (414) 704-6731 (direct). We also have a confidential submission form on our website and a Medicare fraud information page.
MahanyLaw – America’s Whistleblower Lawyers