Richard E. Paulus, MD, a cardiologist from Ashland, Kentucky, was found guilty of placing unnecessary coronary stents and performing unnecessary diagnostic catheterizations in patients.
Paulus faces up to 20 years in jail for healthcare fraud and up to five years for making false statements, according to a Department of Justice news release. He is expected to be sentenced on April 25, 2017, but The Daily Independent newspaper in Louisville reported that Paulus will likely appeal the decision.
Federal authorities allege that Paulus performed numerous invasive heart procedures that were medically unnecessary from 2008 to 2013 when he worked at King’s Daughters Medical Center in Ashland. They also allege that he falsified their medical records and fraudulently billed Medicare, Medicaid and private insurance companies. For instance, he allegedly placed coronary stents in more than 70 patients whose blockages were less than 70 percent, but he tracked them as more than 70 percent to get reimbursed.
During the trial, 10 cardiologists testified against Paulus, according to the news release. Paulus billed Medicare for more heart procedures than any cardiologist in Kentucky did from 2006 to 2012, according to authorities. During that time period, only four other cardiologists in the U.S. received higher payments from Medicare for stent procedures.
King’s Daughters Medical Center agreed in May 2014 to pay the federal government $40.9 million in a civil settlement based on performing unnecessary heart procedures.
After Paulus’s conviction, King’s Daughters released a statement to the Courier-Journal newspaper in Kentucky and said that “we hope Dr. Paulus will be successful in his appeal of this decision.” Paulus, who retired last year, has a heart and cardiovascular center named after him at King’s Daughters.
“Since the beginning, King’s Daughters has stood behind our cardiac program,” King’s Daughters said in the statement. “Our heart program has continued to meet or exceed national performance standards. Independent experts have been reviewing our cases and agree that the heart care we provide is excellent.”