Cardiologist Settles Suit for $5.8M for Alleged Unneeded Stents

Ken Terry

June 04, 2019

Joseph P. Galichia, MD, a Wichita, Kansas, cardiologist, has agreed to pay $5.8 million to resolve allegations that he and his medical group, Galichia Medical Group (GMED), improperly billed federal health programs for medically unnecessary cardiac stent procedures, the Department of Justice (DOJ) announced on May 30.

Galachia also agreed to a 3-year period of exclusion from participation in any federal health program, the DOJ news release said.

The government contended that Galichia and GMED knowingly submitted false claims for the allegedly unnecessary procedures from 2008 through 2014. The allegedly false billings were submitted to Medicare, the Defense Health Agency, and the Federal Employees Health Benefit Program.

The settlement resolves allegations in a qui tam (whistle-blower) lawsuit filed by Aly Gadalla, MD, in the United States District Court for the District of Kansas. Gadalla, an internist who formerly worked for GMED, will receive approximately $1.16 million from the settlement.

"This settlement reflects the Department of Justice's commitment to ensuring the safety of federal health care program beneficiaries and that taxpayer monies are properly spent," said Assistant Attorney General Jody Hunt, of the Department of Justice's Civil Division, in the news release.

In a statement posted on the website of KSN, a Wichita TV station, representatives of Galichia and GMED noted that the settlement did not constitute an admission of liability and that Galichia denied the allegations in the lawsuit. The statement described Gadalla, the whistle-blower, as a "former disgruntled employee."

According to the statement, the government's only witnesses in the qui tam lawsuit were two noninterventional cardiologists, neither of whom was currently in full-time practice. "The Galichia Team, on the other hand, engaged four prominent cardiologists who each found that Dr Gilachia's stent procedures were appropriate under American Heart Association/American College of Cardiology guidelines," the statement said.

The statement also said that angiographic images — which are used in determining whether a patient needs a stent — can be interpreted in more than one way. "Because of the subjective nature of visual lesion assessment, there is a 20% variation between the readings of two or more experienced angiographers, especially for lesions narrowed 40–70%," it said.

Third Settlement

This settlement is the third False Claims Act settlement with Galichia and GMED, the DOJ press release noted. In 2009, the cardiologist and his multispecialty group paid $1.3 million to settle allegations that they submitted claims for services not provided or that lacked proper documentation.

In 2000, the DOJ said, they paid $1.5 million to settle allegations that they had submitted claims for a higher level of service than provided, billed twice for the same services, and billed for services not provided.

In an announcement to GMED patients on June 1, 2018, Galichia said that the group had been sold to HCA Wesley, which is affiliated with the HCA-owned Wesley Medical Center in Wichita. Two other cardiologists who had worked for GMED joined a local cardiology group. According to a KSN article, Galichia is no longer in practice but may return to medical practice in the future.

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