Newark, NJ - The US federal government is suing two cardiologists with regard to their alleged roles in a kickback scheme involving the University of Medicine and Dentistry of New Jersey (UMDNJ) [1,2]. The NJ district attorney has filed civil lawsuits in the past few weeks against Dr Joseph Campbell of Orange, NJ and Dr Atul Prakash, of Cedar Grove, NJ.

The two community cardiologists were given the titles of assistant professors at the university hospital, with salaries, and were supposed to work there part-time, performing specific teaching, research, and patient-care duties. But instead, it is claimed that they merely referred patients to prop up an ailing cardiac surgery program at the hospital.

The two are among a group of at least 16 community cardiologists who are said to have participated in the scam, which came to light in 2006 during a two-year federal monitorship of the university by former federal Judge Herbert J Stern. Stern concluded that the community cardiologists were expected to do little more than refer patients to the cardiac surgery program to ensure that it would not lose its state accreditation. He also accused the then-interim president of UMDNJ, Dr Bruce Vladeck, and other university administrators of intentionally misleading investigators and attempting to bury previous concerns raised about the illegal referral program.

According to the lawsuits, Campbell and Prakash are guilty of violating both the federal Stark statute—which prohibits referral of Medicare patients to a hospital at the same time that the doctors have financial relationships with that hospital—and the False Claims Act, which states that submission of false claims based on a prohibited financial relationship allows the government to seek triple damages.

The government is seeking more than $2.5 million in damages from Prakash: $357,000 equaling three times the annual salary he took from the university in 2004 and almost $2.4 million representing triple the amount of $794,000 that he received from Medicare for more than 30 patient referrals. From Campbell, it is seeking $210,000 in damages—equivalent to three times the annual salary he was paid by UMDNJ in 2003—plus $165,000, which is three times the total amount paid to him by Medicare for patient referrals.

Prakash's lawyer, Sean Buckley, told the Newark Star Ledger [3]: "My client denies all the allegations being made. The complaint is riddled with factual inaccuracies. Dr Prakash performed all the bona fide services requested that he perform in the contract, and we look forward to taking this case to trial to obtain a vindication."

In February, two other private-practice cardiologists, Dr Bakul Desai, of Livingston, NJ and Dr Laxmipathi Garipalli, of Colts Neck, NJ, pleaded guilty in federal court to criminal embezzlement charges for participating in the same fraudulent conduct and taking salaries totaling $840,000 between them.

According to the Star Ledger, these two are now cooperating with the US attorney's office and the FBI in the investigation and face a possible suspension of their licenses once the state Board of Medical Examiners reviews their convictions.

"There are still others who engaged in the same conduct, and we will use both criminal and civil remedies as needed to achieve justice and the return of money received by fraud from the Medicare program," NJ District Attorney Christopher J Christie said in a statement.

When asked by heartwire about when further charges might be brought against other individuals, Christie's spokesperson, Mike Drewniak, said: "We can't answer questions about what we intend or expect to do until we actually do it."

UMDNJ spokesperson Anna Farneski told heartwire: "Since the concerns over the community cardiology program were raised in the fall of 2006, the UMDNJ Board of Trustees and management have worked aggressively with the former federal monitor and the New Jersey attorney general's office in restructuring the community cardiology program.

"We are implementing the recommendations of this ad hoc committee, which . . . include: a reduction in the number of cardiologists from 18 to four based on patient need; a review of salaries for remaining community cardiologists and adjustment based on market conditions; and the creation of tracking mechanisms to ensure compliance with work expectations, including time and effort reports."

The kickback scheme came to light in 2006 during the two-year federal monitorship of the university, a result of claims that it was overbilling Medicaid and Medicare. The US attorney had said it would indict the university but, pleased with the reforms made by the institution, it terminated a deferred prosecution agreement in January of this year.

"There is no doubt that the reforms to the cardiology program, along with many others instituted here during the past two years, prompted the US attorney to terminate the deferred prosecution agreement in January," Farneski told heartwire. "To quote the federal monitor in his final report, 'We are gratified to report that UMDNJ is a much-changed institution. The changes at UMDNJ—though still in progress in many respects—are noteworthy. From the top down, UMDNJ has undergone major personnel, policy, and cultural changes.'"