The United States Justice Department has intervened in a False Claims Act lawsuit alleging that Satilla Health Services, Inc., dba Satilla Regional Medical Center, and Dr. Najam Azmat submitted claims to Medicare and Medicaid for medically substandard and unnecessary services.

Among other things, the complaint alleges that the defendants submitted claims for medical procedures performed by Dr. Azmat in Satilla's Heart Center that the physician was neither qualified nor properly credentialed to perform. As a result, at least one patient died and others were seriously injured.

The complaint states that Satilla placed Dr. Azmat on staff even after learning that the hospital where he previously worked had restricted his privileges as a result of a high complication rate on his surgical procedures. The complaint also states that after Dr. Azmat joined the Satilla staff, the hospital management allowed him to perform endovascular procedures in the hospital's Heart Center even though he lacked experience in performing such procedures and did not have privileges to perform them.

Again, according to the complaint, at least one of Dr. Azmat's endovascular patients died as a result of him perforating the patient's renal artery, causing her to bleed to death. Dr. Azmat allegedly did not even recognize that he had perforated the patient's artery and failed to take appropriate action to address the complication.

The complaint further states that the nurses in Satilla's Heart Center recognized that Dr. Azmat was incompetent to perform endovascular procedures and repeatedly raised concerns with hospital management. Despite the nurse's complaints and Dr. Azmat's high complication rate, Satilla's management continued to allow him to perform endovascular procedures and to bill federal health care programs for these services.

“In this case, the defendants allegedly not only provided substandard and unnecessary medical services - they caused harm to patients,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “We are committed to bringing to justice those who put profits ahead of patient health and safety.”

This lawsuit was originally filed by Lana Rogers, a nurse who formerly worked in Satilla's Heart Center. Under the qui tam, or whistleblower, provisions of the False Claims Act, a private citizen can file an action on behalf of the United States and receive a portion of any recovery. The act permits the United States to recover three times the amount of its losses, plus civil penalties.

The United States' intervention is part of the government's emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover approximately $2.3 billion since January 2009 in cases involving fraud against federal health care programs.

SOURCE U.S. Department Of Justice