Manhattan U.S. Attorney Announces Indictment And Arrest Of Vascular Surgeon For Healthcare Fraud
Government Also Files Civil Fraud Complaint Against the Surgeon and His Medical Practice
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, and Scott Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General’s (“HHS-OIG”) New York Region, announced today that FENG QIN, M.D. (“QIN”), a vascular surgeon with practices in Lower Manhattan and Far Rockaway, Queens, has been indicted for healthcare fraud and that the United States has filed a civil fraud complaint against him and his medical practice, QIN MEDICAL P.C., under the False Claims Act. Specifically, the Indictment and Civil Complaint charge QIN with fraudulently billing Medicare for performing vascular surgery procedures on patients that were not medically reasonable and necessary or covered under Medicare rules. QIN will be presented before U.S. Magistrate Judge Ona T. Wang this afternoon. QIN’s case is assigned to U.S. District Judge Ronnie Abrams.
In 2015, this Office filed and simultaneously settled a civil fraud lawsuit against QIN and his previous employer for engaging in fraudulent billing practices during the time period 2010 through 2012. As part of that settlement, QIN paid $150,000 and admitted that he was familiar with the applicable Medicare rules and that he had regularly performed vascular surgeries on patients who had not exhibited symptoms justifying the procedures. As charged in the Indictment and Civil Complaint, QIN later opened his own surgical practice and continued to engage in the same fraudulent conduct.
Manhattan U.S. Attorney Geoffrey S. Berman said: “As alleged, Feng Qin clearly did not learn his lesson from the previous civil suit this Office filed against him for healthcare fraud – that he must follow Medicare rules and stop billing for surgical procedures that are not clinically justified. He is now being charged criminally for his alleged failure to do so.”
HHS-OIG Special Agent in Charge Scott Lampert said: “Performing medically unnecessary services for the purposes of financial gain will not be tolerated. HHS-OIG is committed to holding providers accountable and protecting the integrity of our nation’s federal healthcare programs.”
According to the Indictment[1] and the Civil Complaint:
Patients with end-stage renal disease (“ESRD”) who are receiving dialysis may require vascular access surgical procedures, such as fistulagrams, where dye is injected into the patient’s vein or artery to visualize blood flow, and percutaneous transluminal angioplasties, in which wires and balloons are inserted into blood vessels that have narrowed in order to restore blood flow. However, as Medicare billing guidelines made clear, it is not reasonable and necessary for physicians to bill the program for fistulagrams and angioplasties unless the patient has specific and documented clinical problems, such as significant difficulty receiving dialysis properly.
The patients at QIN’s medical practice primarily consisted of ESRD patients undergoing dialysis treatment. During the relevant period, from 2015 to 2016, QIN routinely scheduled patients for fistulagrams and angioplasties three months in advance, and performed fistulagrams and angioplasties on these patients as a matter of routine, regardless of whether there was a justifiable clinical reason to do so. Furthermore, he sometimes misrepresented the medical conditions of patients in their medical records to make it seem as if they suffered from symptoms that would warrant the procedures when they did not. QIN’s practice unlawfully billed and received payment from Medicare for these procedures, which were excluded from Medicare coverage, as he knew.
The allegations of fraud stated in the Civil Complaint were first brought to the attention of federal law enforcement by a whistle-blower who filed a lawsuit under the False Claims Act.
The criminal case is being handled by the Office’s General Crimes Unit. Assistant United States Attorneys Jean-David Barnea and Michael K. Krouse are in charge of the case. The civil case is being handled by the Office’s Civil Frauds Unit. Assistant United States Attorney Barnea is in charge of the case.
[1] As the introductory phrase signifies, the entirety of the text of the Indictment and the description of the Indictment set forth herein, constitute only allegations, and every fact described should be treated as an allegation.