Cardiac surgery group pays $2 million to settle whistleblower (qui tam) lawsuit alleging Medicare fraud

Feb. 1, 2001 — A cardiac surgery group based in Rochester, New York, will pay $2 million to the federal government to settle a whistleblower ("qui tam") case that charged it illegally billed Medicare for services, the government announced today.

The lawsuit charged that Genesee Valley Cardiothoracic Group submitted false claims to Medicare for the services of "assistant attending surgeons" during surgery. Qualified cardiothoracic residents were present at those times, which under Medicare regulations means that the health care provider can't bill for assistant attending surgeons. Medicare generally prohibits payments in those instances because it already directly pays teaching hospitals for the cost of providing qualified residents.

"This action concerns not the practice of medicine or the rules of medicine but payments," Assistant U.S. Attorney Robert Trusiak, who handled the case, told the Rochester Democrat and Chronicle.

Dr. Richard Feins, a thoracic surgeon, brought the qui tam lawsuit against Genesee Valley.

"The residents were aware of the fact that, even though they were assisting on surgeries, additional people were being brought in to assist in what they thought was a very trivial way," Feins told the newspaper.

Feins will receive a share of the settlement, as provided under the False Claims Act. He was represented by the law firm of Phillips & Cohen LLP.

For more information about this case, see the following news story:

  • "Heart bypass unit fined $2 million," Gary Craig, Rochester Democrat and Chronicle, 2/2/01.