Dr. Hari Saini and his practice, Carolina Heart and Leg Center, agreed to the sum as part of a civil fraud settlement.
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"This civil fraud settlement demonstrates our steadfast commitment to protect taxpayer money and guard the integrity of our vital health care programs," said U.S. Attorney Michael Easley. "Medical doctors should never bill for unnecessary procedures. Those who do will be held accountable. Our office will zealously pursue damages and civil penalties against medical professionals where warranted."
This settlement stemmed from whistleblower allegations that Saini and his cardiology practice performed unnecessary atherectomy procedures to remove minor plaque blockage in leg arteries in patients.
A federal complaint alleging that Saini and his office "systematically overstated the stenosis percentage" to justify medically unnecessary atherectomies for the maximum number of procedures for their patients.
More specifically, the government alleged that Saini - who was one of the highest billing cardiologists in North Carolina for this type of claim - conducted "risky and invasive atherectomy procedures to unnecessarily remove plaque blockage that was, at best, only minimally present, all in blatant disregard for patient safety and Program billing requirements."
Based on billing and medical records, the defendants were paid millions from Medicare and Medicaid.
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After six years of investigation and with a trial looming, Saini agreed to the settlement, the DOJ said.
"Physicians cannot perform procedures on patients who don't need them just to make more money," said North Carolina Attorney General Josh Stein. "That's a waste of taxpayer resources and a fundamental abuse of the trust we put in doctors. My office will hold accountable health care providers when they commit fraud for their own enrichment."
The federal and state False Claims Acts mandate that the governments recover triple the money falsely obtained, plus substantial penalties for each false claim submitted, and attorneys' fees and costs to the whistleblower.
Saini and his practice have denied the fraud allegations. Carolina Heart and Leg Center has locations in Fayetteville, Lumberton, Erwin and Saint Pauls.
According to his bio, Saini moved to Fayetteville in 2003 and opened Carolina Heart and Leg Center in 2013.