Jitesh Patel, an Indian American urologist in Atlanta, will pay $14 million to resolve allegations of fraudulent billing and unnecessary medical procedures involving federal healthcare programs.
Jitesh Patel, an Indian American urologist based in Atlanta, Georgia, and his practice, Advanced Urology, have agreed to pay $14 million to settle allegations related to fraudulent billing practices and unnecessary medical procedures. This settlement stems from a False Claims Act case initiated after a whistleblower complaint was filed by a former employee.
The investigation revealed serious allegations against Advanced Urology, including claims that the practice performed unnecessary medical procedures. According to a press release from the U.S. Attorney’s Office for the Northern District of Georgia, a second whistleblower complaint further alleged that the practice billed government healthcare programs for tests and procedures that were either not performed or deemed medically unnecessary.
Among the specific allegations, the whistleblowers claimed that Advanced Urology was structured to maximize revenue for Patel and his associates by conducting medically unnecessary tests and procedures. One notable example cited was the billing for a procedure known as Direct Visual Internal Urethrotomy (DVIU), which the practice allegedly never performed. The DVIU procedure involves using a scope to dilate the urethra and cutting tissue within it. Instead, Advanced Urology reportedly performed a simpler dilation of the urethra but billed for the more complex DVIU procedure to receive higher payments from government healthcare programs.
The whistleblowers contended that Patel and Advanced Urology’s actions resulted in the submission of false claims to federal healthcare programs, including Medicare and Medicaid. Under the provisions of the False Claims Act, private citizens can file lawsuits for false claims on behalf of the United States and are entitled to a share of any recovery obtained by the government. As part of the settlement, the whistleblowers will collectively receive $2.94 million.
U.S. Attorney Theodore S. Hertzberg emphasized the seriousness of the allegations, stating, “Physicians commit fraud when they seek payment for medically unnecessary procedures or bill for services they never performed. Our office will not tolerate abuse of patients or misuse of government funds, and we will enforce the False Claims Act to hold wrongdoers accountable.”
Kelly Blackmon, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), echoed this sentiment, stating, “This action underscores our commitment to safeguarding federal healthcare programs from fraud and abuse.”
The settlement marks a significant step in addressing fraudulent practices within the healthcare system and highlights the role of whistleblowers in bringing such misconduct to light. The case serves as a reminder of the importance of accountability in healthcare and the ongoing efforts to protect patients and government resources.
For more information, refer to the press release from the U.S. Attorney’s Office for the Northern District of Georgia.
