Vascular Surgeon to Pay $800,000 for Performing Unnecessary Procedures—Again

March 29, 2021 | Strategic Insights for Ambulatory Care


A vascular surgeon has agreed to pay $800,000 and will be barred from participating in federal healthcare programs for four years to resolve civil and criminal charges for billing Medicare for medically unnecessary procedures, according to a March 8, 2021, news release from the U.S. Attorney's Office for the Southern District of New York.

Most of the patients in the surgeon's medical practice had end-stage renal disease (ESRD) and were undergoing dialysis. Some patients with ESRD undergoing dialysis require procedures such as fistulagrams or percutaneous transluminal angioplasties. In a fistulagram, dye is injected into a blood vessel to visualize blood flow. In percutaneous transluminal angioplasty, wires and balloons are inserted into narrowed blood vessels to improve blood flow. Under Medicare billing guidelines, providers may bill for fistulagrams and angioplasties only if...

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