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Cardiologists hit Citizens with 2nd lawsuit

By JR Ortega
April 13, 2013 at 10:01 p.m.
Updated April 13, 2013 at 11:14 p.m.

Three cardiologists feuding with Citizens Medical Center are again suing the county hospital, claiming it gave kickbacks to several of its staff physicians.

The federal Office of Inspector General is investigating the allegations, hospital lawyer Kevin Cullen confirmed.

The lawsuit, filed by Victoria cardiologists Drs. Dakshesh "Kumar" Parikh, Harish Chandna and Ajay Gaalla on behalf of the United States, claims the hospital gave kickbacks to several employed physicians in exchange for patient referrals.

The lawsuit names several hospital staff members, including emergency room physicians and gastroenterologists.

The lawsuit, filed in 2010, was sealed until late February, when the U.S. Attorney for the Southern District of Texas sent an order saying the U.S. "is not intervening at this time." The inspector general's office would not comment on its investigation.

The 53-page lawsuit claims the hospital presented false and fraudulent payment claims to the government, which would be a violation of the False Claims Act.

Cullen said the inspector general's office subpoenaed the hospital in February, but Citizens officials were unaware of the lawsuit until they were served last week.

"We intend to vigorously defend the lawsuit," Cullen said.

Cullen and Gary Eiland, a Houston lawyer specializing in health care law, are working with the hospital to issue a response to the suit, due in May, Cullen said.

Cullen would not comment further about the lawsuit, and neither would Eiland, who said he was still gathering information about the suit.

"We're still assessing the allegations," Eiland said. "It's really premature."

Eiland did say that qui tam lawsuits, a lawsuit in which plaintiffs act on behalf of others, are becoming more common.

"There is a proliferation of qui tam lawsuits against health care," he said.

Neither the cardiologists nor their lawyer could be reached for comment to explain why they chose to file a suit on behalf of the government rather than report their concerns to an investigating agency.

The lawsuit alleges the hospital paid bonuses to its ER physicians for referrals to the hospital's chest pain center.

Once referred to the pain center, the hospital performed unnecessary nuclear stress tests, even on patients of the three cardiologists without their knowledge, the lawsuit claims.

Between Sept. 16, 2008, and March 18, 2010, the hospital paid emergency room physicians $647,049.25 in bonuses, according to the lawsuit. Between March 18, 2010, and July 22, 2010, an additional $190,665 was paid.

The three cardiologists claim the hospital administration was purposely steering patients from them to the hospital in order to make more money through unnecessary testing.

The lawsuit also stated the hospital violated the Anti-Kickback Act and the Stark Act by providing discounted office space to its cardiologists.

The lawsuit also claimed gastroenterologists participating in the hospital's colonoscopy screening program received illegal compensation for referrals to the hospital.

Though the suit is just coming to the surface, the incidences in question date asfar back as 2007.

According to details in the lawsuit, both Dr. Yusuke Yahagi, a Citizens cardiologist, and David Brown, hospital chief executive officer, sent letters to the three cardiologists questioning why they were not referring patients from their private practice on Red River Street to Citizens.

The three cardiologists claim Yahagi had a high mortality rate with his patients, and they were doing what was in the best medical interest of the patient.

In February 2010, the hospital passed a resolution that granted its cardiologists exclusive right to practice at the hospital, barring Parikh, Chandna and Gaalla from being able to work at Citizens.

In response, the cardiologists filed a 2010 lawsuit.

That lawsuit was settled in December 2012, with the three cardiologists accepting an $8 million settlement in the case.

Brown would not comment on specific allegations of this newest case but did say the entire lawsuit "is all very confusing."

"It's important to understand that this action looks exactly like that other action," Brown said comparing the two lawsuits.


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