NY Patients Subjected To Painful Procedures In Medicare Fraud: Feds

NEW YORK — A healthcare company with outposts in New York City and Long Island stands accused of subjecting elderly patients to painful procedures they didn't need as part of a scheme to defraud Medicare, prosecutors contend.

The U.S. Attorney's office filed Tuesday a civil complaint in Brooklyn federal court against Fresenius Vascular Care, a Pennsylvania-based healthcare company that specializes in chronic kidney disease, court records show.

One patient, 68, was allegedly subjected to 22 procedures over the course of four years on 11 separate dates at a site in Queens, according to the complaint, which said minorities and elderly patients were often targeted in the scheme.

“The conduct alleged in this case is egregious, as Fresenius not only defrauded federal healthcare programs but also subjected particularly vulnerable people to medically unnecessary procedures,” U.S. Attorney Breon Peace in a statement.

“This Office will hold medical providers accountable for practices that needlessly expose patients to harm for financial gain at taxpayer expense.”

Earlier complaints were also filed by Dr. John Pepe and Dr. Richard Sherman, board-certified nephrologists, who were whistleblowers for the case.

Pepe said he saw firsthand how Fresenius put patients in harm's way to support their bottom line.

“The practice of conducting medically unnecessary procedures, especially on such chronically ill patients as those with end stage renal disease, is unethical, unlawful and should be stopped,” Pepe, an attending physician at Richmond University Medical Center and Staten Island University Hospital, told Patch via email.

Pepe's lawyer, Jeanne Markey, co-chair of the Whistleblower/False Claims Act practice at Cohen Milstein, Sellers & Toll, is grateful that the U.S. Attorney for taking the case.

“When health care providers take advantage of patients’ trust, the government and taxpayers, all in the name of profit, they should be held accountable,” said Markey.

The company, which does business as Azura Vascular Care, billed Medicare and other federal health care programs at nine sites in New York City and Long Island for medically unnecessary procedures, prosecutors said.

About 60 patients who needed need kidney transplants or dialysis received unnecessary treatments that cost nearly $7,000 each over the course of five years Jan. 1, 2012 to June 30, 2018, according to the complaint.

The total cost tally was not disclosed in court documents, but the government is entitled to recover three times the amount of each penalty under the False Claim Act, if Fresenius were to lose the case.

A Fresenius spokesperson denied the charges and told Patch company policy is to provide the highest quality care.

“Our policies are intended to result in a high standard of care and compliance with government regulations,” an FMC spokeswoman said via email Wednesday.

“We dispute the allegations contained in both the [nephrologist’s] complaint and the US government’s complaint and intend to vigorously defend the litigation.”

Patients referred once to Fresenius — to see if they needed further kidney treatment that would help their body excrete waste — were then told they were sicker than was actually true and to come back for multiple medical procedures, prosecutors said.

The government is seeking relief for payment under mistake of fact, unjust enrichment, and three more counts related to false records.

The complaint added that SEC filings reported between 2012 to 2018 allegedly found that 31 to 34 percent of FMC’s total revenue came from reimbursements from the federal healthcare system.

“The alleged conduct by Fresenius unnecessarily compromised patient care and undermined the financial integrity of federal health care programs,” said Agent-in-Charge Scott Lampert of the U.S. Department of Health and Human Services, Office of Inspector General’s Office of Investigations, in a statement.

“Along with our law enforcement partners, HHS-OIG is committed to protecting beneficiaries and taxpayers from such abusive practices.”

The defendants operated vascular access centers at the following locations:

NEW YORK CITY

• American Access Care Brooklyn — 577 Prospect Ave. in Windsor Terrace, Brooklyn
• American Access Care Queens — 176-60 Union Turnpike in Queens
• American Access Care of New York (now American Access Care Manhattan) — 403 E. 91 St., on the Upper East Side in Manhattan
• American Access Care Bronx — 1200 Waters Place in The Bronx
• Saqib Chaudhry, MD — 176-60 Union Turnpike in Queens
• Verrazano Vascular Associates at Access Care Physicians — 2025 Richmond Ave. in Staten Island

LONG ISLAND

• American Access Care of Bellmore (now American Access Care Nassau County) —
250 Pettit Ave. in Bellmore

• American Access Care — 32 Central Ave. in Hauppauge

Saqib Chaudhry, MD — 1044 Northern Boulevard in Roslyn

This story was updated to include Dr. Pepe's statements.