Arizona Cardiology Group Pays $4.75M to Settle False Claims Allegations

PHOENIX – Tri-City Cardiology, P.C., a physician group based in the Phoenix metropolitan area, and three individual physicians have agreed to pay $4.75 million to resolve allegations of violating the False Claims Act. The allegations center around the performance of medically unnecessary vein ablations between January 1, 2017, and April 27, 2022.

Details of the Settlement

The settlement involves Dr. Jaskamal Kahlon, Dr. Joshua D. Cohen, and Dr. M. Joshua Berkowitz, who allegedly performed ablations on perforator veins that did not meet accepted medical standards for treatment according to the Department of Justice. The United States contends that the group knowingly falsified medical records to justify these procedures.

Government Response

Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division emphasized that “Physicians should not prioritize profit over patient needs,” and that federal programs only cover medically necessary care that meets established standards as reported by the Department of Justice. U.S. Attorney for the District of Arizona, Timothy Courchaine, added that paying for unnecessary procedures diminishes resources available for necessary care and that his office will continue to pursue recoveries to protect taxpayer funds .

Tri-City Cardiology’s Response

Tri-City Cardiology released a statement asserting their disagreement with the government’s allegations, stating they “unequivocally deny that our physicians knowingly submitted false claims or performed medically unnecessary procedures.” They maintain that the care provided was consistent with the 2020 Appropriate Use Criteria and the Medicare “reasonable and necessary” standard as reported by KVOA. The group highlighted their full cooperation with the inquiry, providing over 150,000 pages of medical records, and imaging.

Settlement Details and Future Operations

The settlement does not include any contention of patient harm or patient complaints. Tri-City Cardiology will remain eligible to participate in Medicare and other federal health care programs, and the resolution does not require ongoing federal monitoring or a Corporate Integrity Agreement . The group stated their decision to settle was made to avoid prolonged litigation and to maintain focus on providing cardiovascular and vascular care to the East Valley community.

Allegations Detail

The United States alleges that Tri-City and the physicians acted knowingly in incorrectly measuring or documenting the duration of outward blood flow, the diameter of veins, patient symptoms, and conservative therapy measures, creating the appearance that the ablations were medically justified according to the Arizona Daily Independent.