Crime

Former cardiologist at St. Joseph London pleads guilty to health care fraud

A former Saint Joseph London cardiologist pleaded guilty to health care fraud for submitting a claim for an unneeded heart stent procedure, according to federal court documents.

Sandesh Rajaram Patil, 51, admitted Tuesday to lying about the severity of a patient's condition to receive payment for a heart procedure.

He admitted guilt in one case that occurred in February 2009 for which the government paid $6,088 to the hospital where he practiced, according to the guilty plea.

Patil practiced at Saint Joseph in London, which has repaid the government $256,800 for Patil's false claims in 2009 and 2010, a press release from the U.S. Attorney's office said. Patil is the third cardiologist nationwide and the first in Kentucky to be prosecuted for health care fraud related to heart stents, which are metal tubes used to improve blood flow in arteries, according to a news release from Kerry B. Harvey, U.S. attorney for the Eastern District of Kentucky.

Patil believed that the procedures he performed were medically necessary and in the best interest of the patients, his attorney Brian Butler said in an interview Wednesday.

But Butler said Patil wanted to take responsibility for "not recording the proper data" to get reimbursement.

Patil reached an agreement with the U.S. attorney to serve 30 to 37 months, but the agreement has to be approved by a judge. Sentencing is scheduled for Aug. 27.

"Dr. Patil violated the public's trust in physicians," Harvey said. "Both patients and the entities that pay for medical services trust that our physicians will accurately and honestly assess a patient's medical condition. We will aggressively pursue any physician or provider that breaches this trust and places their own financial well-being ahead of the well-being of the patients."

A patient must have at least 79 percent blockage of an artery and symptoms of blockage for stents to be medically necessary, the news release said.

Patil admitted that he placed a stent in arteries that had substantially less than 70 percent blockage, but recorded that the blockage was more to guarantee payment from Medicaid, the government health insurance program for the poor and disabled.

Saint Joseph London has cooperated with the U.S. Attorney's office throughout the investigation, David McArthur, a spokesman for KentuckyOne Health, said in an email Wednesday.

"Dr. Patil was not an employed physician, has not had privileges at the London hospital since December 2010 and has not practiced there since," McArthur said.

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