Date: 10-24-2017

Case Style: Denise Pavlat, et al. United States of America v. Digestive & Liver Disease Consultants, P.A., et al.

Case Number: 4:13-cv-00411

Judge: Alfred H Bennett

Court: United States District Court for the Southern District of Texas (Harris County)

Plaintiff's Attorney: Charles Siegel for Denise Pavlat

Michelle Zingaro for the United States

Defendant's Attorney: Thomas L. Mills, Melanie Gray, Lawrence I. Kiern, John B Strasburger

Description: Houston, TX - Former President of Harris County Medical Society and Affiliated Facilities Settle Allegations of Medicare Fraud

Dr. Gurunath Thota Reddy, Memorial Hermann Endoscopy and Surgery Center North Houston, United Surgical Partners International and Digestive & Liver Disease Consultants P.A. entered into an agreement to pay $1,575,000 to settle allegations of Medicare fraud. The claims resolved by this settlement are only allegations and there has been no determination of liability.

The Medicare claims included in the settlement date from April 1, 2007, through Nov. 30, 2014.

An endoscopy nurse formerly employed by Memorial Hermann Endoscopy and Surgery Center initialed the matter. She alleged that Reddy and other physicians who performed colonoscopies at Memorial Hermann Endoscopy and Surgery Center North Houston failed to meet established medical standards. She claimed Reddy and other physicians performed procedures at the center so quickly that they were essentially worthless. By failing to take the necessary amount of time to closely examine the colon, precancerous lesions could be missed.

She also claimed that, in the interest of saving time, the physicians would not always examine the entire colon and would sometimes spend as little as two minutes on a colonoscopy. She also alleged the surgery center did not follow established guidelines for sanitation, claiming Reddy would not put on a clean gown prior to each procedure in order to save money.

“When Medicare pays for a patient to undergo a medical procedure, Medicare expects the health care provider to follow established medical standards of care and sanitation,” said Martinez. “There is no excuse for shortcutting quality in order to increase revenues.”

“Boosting profits with shortcuts to standard medical procedures is unacceptable and at the expense of patient safety,” said Porter. “Working with our law enforcement partners, we will continue to protect Medicare and Medicaid patients from substandard care.”

The experienced endoscopy nurse who brought the allegations further claimed she was fired the day after she complained to the Regional Vice President of United Surgical Partners about the problems she observed.

The FBI, DHHS-OIG and investigators for the U.S. Attorney’s Office conducted the investigation.

Outcome: Settled for $1,575,000.00.

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Defendant's Experts:

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