Berger Montague is pleased to announce that the government has intervened in a False Claims Act lawsuit filed by shareholder Shauna Itri, along with co-counsel, against a cardiovascular center in Texas. The lawsuit alleges that the cardiologist group defrauded the government by billing Medicare for medically unnecessary services.
An example of the medically unnecessary testing alleged in the Complaint is Enhanced External Counterpulsation, or EECP. EECP is a noninvasive treatment that uses timed, sequential inflation of pressure cuffs to augment diastolic pressure, decrease left ventricular afterload, and increase venous return. As the complaint alleges, according to the Medicare Coverage Determination, EECP is very rarely ever medically justified. A full course of EECP consists of 35 one-hour treatments, which may be offered once or twice daily, usually 5 days per week. Each session is billed to Medicare, and the provider receives approximately $137 per session; totaling approximately $4,795 per patient per EECP treatment.