ATLANTA - An Atlanta-based urology practice and its owner will pay $14 million to settle federal allegations of widespread healthcare fraud and performing medically unnecessary procedures on patients.
Federal probe targets Atlanta urology group
What we know:
Advanced Urology, Inc. and Dr. Jitesh Patel settled claims they violated the False Claims Act by billing federal programs like Medicare and Medicaid for services that were either unnecessary or never performed. The government's investigation began after two whistle-blowers ,a former employee and a former physician, filed complaints. The allegations included "upcoding" less complicated procedures to more expensive ones and ordering thousands of unnecessary ultrasounds.
What we don't know:
While the $14 million settlement has been reached, the U.S. Attorney’s Office noted these are allegations only and there has been no formal determination of liability.
It is also unclear if any patients suffered long-term physical harm from the procedures mentioned in the lawsuits, such as unnecessary electrical signal tests or bladder scopes.
Invasive tests and fraudulent billing alleged
By the numbers:
The settlement involves a $14 million total payment to the government. From that amount, the two whistleblowers will collectively receive $2,940,000. The legal action combined two separate lawsuits filed in 2018 and 2019 in the U.S. District Court for the Northern District of Georgia.
Dig deeper:
Whistleblowers claimed the organization was designed to maximize revenue through several specific practices. These included implanting nerve stimulators without testing if they would help, performing bladder scopes on patients under anesthesia without medical need, and conducting electromyography tests on nearly every new patient. They also alleged the practice billed for a "Direct Visual Internal Urethrotomy," which involves cutting tissue with a knife, when they only performed a simple dilation.
Officials vow to protect Georgia taxpayers
What they're saying:
"Physicians commit fraud when they seek payment for medically unnecessary procedures or bill for services they never performed," said U.S. Attorney Theodore S. Hertzberg. Jim Mooney, Deputy Attorney General of Georgia’s Medicaid Fraud Division, added, "Fraud against the Medicaid program is stealing from Georgia taxpayers – plain and simple." Special Agent Peter Ellis of the FBI noted the scheme "prioritize profit over patient care."
Local perspective:
The case impact's Georgia residents who utilize Medicaid and veterans in the Atlanta area who rely on TRICARE or VA healthcare programs. Officials emphasized that performing unnecessary procedures diverts limited resources away from Georgia patients who truly need medical intervention.
The Source: The information in this story was gathered from the U.S. Attorney's Office for the Northern District of Georgia.