January 8th, 2013
Could You Be Accused of Doing Unnecessary PCI?
Last week, the Missouri licensing board urgently suspended a cardiologist accused of implanting unnecessary stents, and an Ohio hospital and cardiology group agreed to pay the United States government $4.4 million to settle accusations that it billed Medicare for unnecessary PCIs performed from 2001 to 2006. According to the U.S. Attorney’s Office, “the claims resolved by this settlement are allegations only, and there has been no determination of liability.”
Were the allegedly unnecessary PCIs a function of financial incentives, professional training, or the perceived benefits of this treatment?
We’ll likely never know, but the Missouri physician is disputing the charges against him, and the founder and chairman of the Ohio cardiology group writes, “….when these decisions were made and the procedures were performed, we felt confident we were making the correct choices for our patients. We still do…”
The hospitals didn’t have a problem with the procedures. UnitedHealth designated the Ohio hospital as one of its “centers of excellence for heart care,” and Medical Mutual of Ohio described it as “a very high-quality provider,” scoring well on traditional quality measures, such as the number of required rehospitalizations and complications, including mortality.
Public confidence is eroding as the number of reports of physician suspensions and monetary penalties for unnecessary PCIs grow. Accordingly, patients are questioning use of PCI, even when it is indicated and advisable.
1. Have investigations into unnecessary stenting changed your interventional practice? How so?
2. Has your group (or hospital) developed policies to evaluate whether PCI procedures are indicated and appropriate? If so, are the policies effective?
3. Do you feel that investigations into unnecessary stenting should be reported publicly– including hospital and provider names – before the findings are known?