Although you are unlikely to face charges at both the federal and state level, your specific circumstances might give rise to that possibility. 

Cases of Healthcare Fraud Involving Cardiologists:

Cardiologists have been involved in various healthcare fraud cases, with penalties ranging from civil settlements to federal prison sentences. Below are just a handful of examples:

Example #1: New Jersey cardiologist Shashi Agarwal was charged with taking part in a cash kickback scheme after he accepted over $100,00 in cash from a diagnostic testing facility in exchange for referring his patients there.  

Agarwal agreed to refer a certain number of patients per month and was paid $100 per Medicare or Medicaid patient he referred for an MRI, and $50 each per CAT scan patient. As such, Agarwal accepted a plea deal imposing 30 months in prison, as well as two years of supervised release and 100 hours of community service.  

Example #2: Tennessee cardiologist Elie H. Korban was charged with billing Medicare and Medicaid for medically unnecessary cardiac stent placements. Cardiac stents treat coronary heart disease and are surgically placed in the coronary arteries of patients to keep their arteries open. These treatments jeopardized the health of countless patients.  

Korban agreed to pay $1.15 million to resolve the claims and entered into an Integrity Agreement with the Department of Health and Human Services, which imposed greater regulations on his future activities. The fraud was initially uncovered by a fellow doctor under the whistleblower provision of the False Claims Act.

Example #3: New Mexico cardiologist Roy G. Heilbron pleaded guilty in 2017 to healthcare fraud after he executed a scheme to defraud Medicare and other health care benefit programs by submitting fraudulent claims. The scheme included billing for unnecessary tests on every new patient, justified by false diagnoses, symptoms, and observations.

Heilbron also up-coded the services he provided in reimbursement claims, and falsely documented unperformed procedures to gain reimbursement for unprovided services.  

He agreed to pay restitution for the criminal conduct as part of his plea agreement and was sentenced to two years in federal prison followed by a period of supervised release.  

Example #4: Kentucky cardiologist Dr. Anis Chalhoub was convicted of healthcare fraud after unnecessarily implanting over 200 pacemakers in patients. Chalhoub fraudulently told patients they could die if they did not undergo the invasive procedure they did not need.

He was sentenced to 42 months in federal prison, forced to pay $300,000 in fines and is prohibited from practicing cardiology for three years after his prison release.  

Example #5: Nevada cardiologist Dr. Devendra Patel was charged with 3 counts of healthcare fraud and 36 counts of distribution of controlled substances, including oxycodone and hydrocodone. 

Patel was accused of prescribing addictive pain medications to patients without a legitimate medical purpose, and for fraudulently billing Medicare and Medicaid for unprovided services.  

Patel was the first person charged in Nevada following the establishment of the Justice Department’s Opioid Fraud and Abuse Detection Unit, that was created under Attorney General Jeff Sessions in 2017. The unit was created to combine data analysis forces with Assistant District Attorneys throughout the country to resolve the opioid epidemic  

While the case is still being prosecuted, Patel could face significant jail time, fines, and the loss of his medical license if convicted.  

Example #6: Ohio cardiologist Dr. Harold Persaud was convicted of one count of healthcare fraud, 13 counts of making false statements and one count of engaging in monetary transactions in property derived from criminal activity. His activity overbilled $7.2 million dollars to Medicare and private insurers.  

Persuad’s six-year scheme defrauded Medicare and other insurers by: