Greedy Doc Inserted Unnecessary Stents For Insurance Money, Feds Say

There’s run-of-the-mill health care fraud, and then there’s really, really disturbing health care fraud. Let’s look at one of the cases that falls into the second category: A cardiologist who inserted unnecessary cardiac stents in patients, ordered unnecessary tests, and made false entries in patient medical records to defraud Medicare, Medicaid, and private insurers. 

The cardiologist is John R. McLean, of Salisbury, Maryland. According to evidence presented at his two week trial, McLean had a private medical practice known as John R. McLean M.D. and Associates, and hospital privileges at the Peninsula Regional Medical Center (“PRMC”). From at least 2003 to May 2007, McLean performed cardiac catheterizations and implanted unnecessary cardiac stents in more than 100 patients at PRMC. He then falsely recorded in the patients’ medical records the existence or extent of coronary artery blockage, known as lesions, observed during the procedures in order to justify the stent and the submission of claims to health care benefit programs, including Medicare and Medicaid.
 
In addition, McLean ordered that his cardiac patients, including those that received stents, undergo a battery of medically unnecessary follow up tests such as cardiolite stress tests, echocardiograms and EKGs. McLean submitted claims for the unnecessary stents and testing that were paid by health care benefit programs, including Medicare and Medicaid.
 
“The jury found that Dr. McLean egregiously violated the trust of his patients and made false entries in their medical records to justify implanting unneeded cardiac stents and billing for the surgery and follow-up care,” said U.S. Attorney Rod J. Rosenstein.
 
“Placing unnecessary stents in the hearts of patients is a crime of unthinkable proportions,” said Nicholas DiGiulio, Special Agent in Charge for the United States Department of Health and Human Services, Office of Inspector General. “A doctor who insists on practicing greed rather than good medicine will ultimately pay a heavy price.”
 
For his crimes, McClean has been sentenced to 97 months in prison followed by three years of supervised release, and he also was ordered to pay restitution to Medicare and the other health insurance programs of $579,070. The court ordered McLean to forfeit $579,070.