Vascular Practice and Physician Agree to Pay More Than $6.73M to Settle False Claims Act Allegations of Unnecessary Vascular Interventional Procedures
Arizona Free Press
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Business and Financial
Serrano Kidney & Vascular Access Center, a physician practice based in Huntington Park, California, and physician Dr. Feliciano Serrano have agreed to pay more than $6.73 million to resolve allegations that they violated the False Claims Act by submitting false claims for medically unnecessary vascular interventional procedures on 20 Medicare beneficiaries.
“Physicians should not be performing and billing for unnecessary and excessive medical interventions. False documentation of symptoms compromises the integrity of our federal health care programs and the well-being of beneficiaries,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “Physicians who place their own profit over patient needs will be held accountable.”
“False claims to Medicare and Medicaid cause millions of dollars in losses to the government,” said First Assistant U.S. Attorney Bill A. Essayli for the Central District of California. “This settlement sends a clear message to physicians that the United States will zealously pursue appropriate action against those who submit false claims for taxpayer funds.”
The United States alleged that from 2016 to 2024, Dr. Serrano performed medically unnecessary dialysis access interventions, including angioplasty and stent procedures, on 18 patients, purportedly to treat stenosis in patients’ dialysis segments. Dr. Serrano scheduled interventions on a routine basis, without waiting for complications to present, and he frequently repeated procedures on patients every few days or weeks despite that the procedures were not effective and did not result in any clinical benefit. One Medicare patient received approximately 42 stents in the dialysis segment between 2016 and 2023, including during a period when Dr. Serrano informed the patient he did not need dialysis.
The United States also alleged that from 2019 to 2024, Dr. Serrano performed medically unnecessary peripheral artery disease interventions, including stent and atherectomy procedures, on 17 patients, purportedly to treat stenosis in patients’ legs. Dr. Serrano performed interventions on patients who had only mild or no stenosis and who had only minor symptoms. Although patients complained of pain only in one leg, he performed procedures on both legs and then repeated procedures on both legs every few months. Dr. Serrano told patients that if they did not receive the procedure, their legs would need to be amputated, when, in fact, there was little risk of amputation for mildly symptomatic peripheral artery disease. One Medicare patient received approximately 16 atherectomies in his legs between 2019 and 2023.
The United States alleged that across both categories of procedures, Dr. Serrano performed interventional procedures on vessels that did not qualify for treatment under accepted standards of medical practice; overstated the degree of stenosis to make the procedures appear to meet generally recognized medical standards when, in fact, they did not; falsely documented patient symptoms and conservative therapy measures in medical records to justify the procedures; and performed procedures in excess of accepted standards of medical practice.
As a result of the settlements, Dr. Serrano will pay nearly $6.51 million to the United States and nearly $229,000 to the State of California.
The civil settlement includes the resolution of claims brought by Lincoln Analytics Inc. under the qui tam or whistleblower provisions of the False Claims Act. Under the act, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned United States and State of California ex rel. Lincoln Analytics Inc. v. Dr. Feliciano Serrano, et al., Civil Action No. 23-cv-04178 (C.D. Cal.). Lincoln Analytics Inc. will receive approximately $976,000 as its share of the federal recovery.