One of the top Medicare billers in the country, Central Florida cardiologist Asad Qamar, is the target of two lawsuits accusing him of systematic Medicare fraud, including padding bills and performing unnecessary procedures.
The U.S. Department of Justice’s civil division has joined in the whistleblowers’ cases on behalf of Medicare and Medicaid taxpayers. The lawsuits, filed in 2011 and 2014, were kept secret while the DOJ investigated and debated whether to join them.
DOJ tends to limit participation to cases in which it thinks it can win a substantial recovery. They were unsealed last week by federal judges in Tampa and Ocala.
One of the whistleblowers is a medical billing consultant, Holly Taylor of Sarasota. The other plaintiff so far has been called only “John Doe.” Under the False Claims Act, the initiators of the lawsuits stand to gain part of the money if a case ends in a settlement or a win at trial.
A call from Health News Florida to Qamar’s practice, the Institute of Cardiovascular Excellence, brought an e-mail response from attorney Greg Kehoe of the law firm Greenberg Traurig. He called the allegations “unsubstantiated” and “baseless,” and promised a vigorous defense.
“Dr. Qamar practices under the highest medical and ethical standards,” Kehoe wrote.
The John Doe complaint accuses Qamar of routinely performing unnecessary tests that brought a high Medicare payment. They include ultrasounds of blood flow in the legs, stress tests and Holter monitoring for the heart, and nuclear imaging. Records would be falsified to include symptoms that would justify the tests, his complaint says.
In a scarier allegation, Doe’s complaint says Qamar performed unnecessary catheterizations of the heart, a procedure that can have life-threatening complications. Cardiac catheterization involves inserting a flexible tube into a blood vessel and snaking it to the heart, injecting radioactive dye and taking nuclear images to show whether the blood is flowing properly in the coronary arteries and within the heart itself. Some patients were also subjected to unnecessary catheterization of blood vessels in arms and legs, the complaint says.
The complaint filed by Holly Taylor focuses more on billing. The consulting company that employed her assigned her as the account manager for Dr. Qamar and the Institute, reviewing their Medicare billings. She alleges that from 2008 to 2011, the US and the state of Florida were defrauded of “tens of millions of dollars.”
Taylor’s complaint says Qamar and the Institute regularly billed for procedures that were not performed at all through “upcoding,” instructing billers to code for more expensive procedures than the ones actually done. Also the physician routinely waived the 20 percent co-payment that Medicare requires patients to pay, Taylor said, probably to keep them from questioning why they were getting so many tests.
Her suit alleges that Qamar sometimes went ahead with catheterizations without first taking a history, examining the patient or checking labs. One patient died,Taylor’s complaint says, because she needed referral to a heart surgeon but Qamar delayed it to put stents in her leg vessels.
If there was any wrongdoing at the Institute, as the suits allege, the Florida Department of Health has not found it. Both of the Qamars have clear disciplinary records with no pending state complaints, according to the DOH web site.
Qamar and the Institute are named as defendants in both lawsuits. One also lists his wife, Dr. Humera Qamar.
The Institute, which was launched in 2009, is based in Ocala and boasts two cardiac catheterization labs. The practice has grown swiftly, with offices in Williston and two in The Villages.
According to the practice’s website, Qamar has recently launched two affiliates, the Institute of Medical Excellence in The Villages and Williston and the Limbstitute Center for Limb Salvage in Tavares.
In a New York Times article in April, Dr. Qamar said his organization has 150 employees and 23,000 patients. The article reported that in a study of U.S. physicians’ Medicare billings in 2012, Qamar was second in the nation, receiving $18.2 million. Medicare paid him four times as much as any other cardiologist.
–Carol Gentry, Health News Florida
Hope in the two years left of this administration the Medicare fraud is completely stopped…as we don’t know if in 2016 the Republicans amy take control and with them again Medicare fraud without investigation and penalty as usual. Furthermore the fraudsters run for office then.
Dan H says
Kinda ironic that all this occurred while Obama and the democrats were in charge!
Maura T says
Dr. Qamar puts his patients first and cares more than any Doctor I have ever met. These are allegations by a disgruntled ex-employee. If you read everything in the article you will notice a vast majority of the facts are missing. It tells you how much he billed medicare in 2012 but fails to mention how many patients he saw. He also has MULTIPLE office locations and MULTIPLE Doctors that work with ICE, Therefore more patients seen equals more charges to insurance. This is classic media manipulation, they take one fact and then surround it with speculation rather than giving you all of the facts. Dr. Qamar has jumped through all of the legal hoops designated by the government for medicaid. I’m not sure if you all know medical billing procedures but before a procedure is done it has to be APPROVED by the INSURANCE company and then before payment is made by the insurance the doctor (Qamar & ICE in this case) has to provide documentation to prove the procedure was necessary. Which means the insurance has now approved the procedure TWICE. And now all of a sudden the insurance is saying we have to look into the billing to see if it really was unnecessary. This is just disgusting that people are trying to ruin the reputation and business of a respectable, caring Doctor like Asad Qamar. I would also like to point out that whistleblowers, which is what these people are claiming to be, stand to get a percentage of the funds recovered IF they find any illegal practices. So by coming forward and starting an investigation they have a chance to receive money. Greed is an ugly monster. If there was no reward – would anyone be trying to do this to a good man.
I didn’t notice any commercial insurance companies listed as plaintiffs with the fraud case. Medicare does not require pre-authorization and it only appears to be questioning the practices billed to Medicare patients. I hope this physician can prove that the greed falls with the whistle blower rather than himself.
Rick Gardner says
Yeah I wonder if his name is on the list of Scott contributors… like minds and all..
Susan H says
I read it this way: Holly Taylor is/was a consultant with the practice billing and management firm, PIP. She was probably in charge of the Qamar practice account from 2008 until 2011. At some time during the engagement, Taylor insisted that she and PIP take over the entire management of ICE. This is a common practice in the consulting business — get in for one engagement and then poke around until you find other opportunities for follow-on work. Taking over the entire management of a practice as large and lucrative as ICE would have been quite a plum for PIP. I am sure that when Taylor lost the ICE account that it had a negative impact on her career and earnings. Now she/PIP contend that their ‘offer’ to take over the management of ICE was altruistic and would safeguard against Medicare fraud which she/they now contend occurred in the practice while she/they were serving as billing consultants.
Dr. Qamar is a brilliant and caring physician who has brought economies of scale to a high demand practice area. The whistleblower, Holly Taylor, is a disgruntled consultant who lost a major, lucrative account by overstepping her authority and aggressively attempting to ‘upscale’ her own engagement with the practice. When he is vindicated, I hope that Qamar goes after Holly Taylor/PIP full bore. However, he is also an absolute gentleman, and probably would not do that.
I am a Medicare patient of Dr. Qamar and I have personally experienced over testing. I have had tests done when I had no symptoms. One sonogram that was scheduled for was questioned by the tester. She asked me why I was having it done. One of his ARPN’s told me he left because of the dishonest medical practices. Two of his employees have told me about his sexually harassing women. These are NOT disgruntled employees. I am not a disgruntled patient. I stopped having tests done by him because I started questioning why. I was told by his staff that it was because he was very caring. I thought it was all about the money and I guess I was right. I am now wondering if my procedures were even necessary. It makes me very angry as a patient and a taxpayer.
Millions of dollars, thousands of Unnecessary angiograms, very organized way of cheating medicare.
It is a shame and disgrace to all Pakistani doctors .Another one is being sentenced is Zahid Imran a psychiatrist