A Arizona cardiology physician group in the Phoenix metropolitan area has agreed to pay $4.75 million to resolve allegations involving medically unnecessary vein procedures billed to federal healthcare programs. The case centers on claims that certain treatments were performed even though patients did not meet the medical standards required for those procedures. The matter has drawn attention within the Arizona cardiology community because it involves billing practices related to specialized vein treatments.
The settlement was announced by federal authorities as part of broader efforts to prevent healthcare fraud and protect taxpayer-funded medical programs such as Medicare. Investigators reviewed medical records and billing practices over several years before reaching the agreement. Officials noted that monitoring billing patterns in areas like Arizona cardiology practices is part of ongoing efforts to ensure federal healthcare funds are used appropriately.
Federal Authorities Announce Settlement in Vein Ablation Case
The case involves Tri-City Cardiology, P.C., a physician group based in the Phoenix area of Arizona. According to federal officials, the organization and several doctors agreed to pay $4.75 million to resolve allegations that they violated the False Claims Act by performing medically unnecessary vein ablations. The case has become a significant compliance issue within the broader Arizona cardiology sector, where medical providers must follow strict standards when performing specialized procedures.
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The physicians named in the allegations include Dr. Jaskamal Kahlon, Dr. Joshua D. Cohen, and Dr. M. Joshua Berkowitz.
Federal officials stated that physicians are expected to prioritize patient care and ensure that medical procedures meet accepted clinical standards. Authorities emphasized that federal healthcare programs are intended to pay only for treatments that are medically appropriate and necessary.
Officials said that when unnecessary medical procedures are billed to federal programs, it not only wastes taxpayer money but also reduces the resources available for patients who truly need care.
The investigation alleged that the cardiology group performed vein ablation procedures on patients whose conditions did not meet the established medical criteria required for such treatments. Authorities noted that compliance with medical documentation standards is particularly important across Arizona cardiology providers, where advanced vascular procedures are increasingly common.
The settlement resolves these allegations without a formal determination of liability.
Allegations Focus on Documentation and Medical Criteria
The allegations cover a period from January 1, 2017, through April 27, 2022. During this time, investigators claimed that ablation procedures were performed on perforator veins, which are small veins that connect deep veins and superficial veins in the legs.
These veins are not always treated with ablation. Medical guidelines generally recommend such procedures only when specific symptoms and diagnostic measurements show that treatment is necessary.
For example, doctors must verify certain clinical factors before performing a perforator vein ablation. These factors typically include the diameter of the vein, the duration of abnormal blood flow, the presence of patient symptoms, and whether conservative treatments have already been attempted.
Conservative treatments often include non-surgical options such as compression stockings, exercise changes, or lifestyle adjustments. These approaches are commonly recommended before surgical procedures are considered.
According to investigators, the United States alleged that medical records sometimes incorrectly documented or measured important clinical details. Authorities claimed that information about vein measurements, blood flow duration, patient symptoms, and prior conservative therapy may have been recorded in ways that made the procedures appear medically justified.
Investigators argued that these records created the impression that the ablation procedures met accepted medical standards when they allegedly did not.
Because federal healthcare programs rely on medical documentation to determine payment eligibility, these records led to claims being submitted and paid by federal programs.
Investigation Led by Federal Justice and Health Officials
The investigation involved several federal agencies and offices working together. The matter was handled by the Justice Department’s Civil Division, specifically the Commercial Litigation Branch’s Fraud Section, along with the United States Attorney’s Office for the District of Arizona.
The case was overseen by Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division and United States Attorney Timothy Courchaine for the District of Arizona.
The investigation also received assistance from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), which often helps review healthcare billing and medical compliance issues.
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Legal work on the case included efforts from Senior Trial Counsel Nicholas C. Perros of the Civil Division’s Commercial Litigation Branch, Fraud Section, as well as Assistant U.S. Attorney Lon Leavitt from the District of Arizona.
Officials highlighted that the False Claims Act remains one of the most important tools used by the federal government to address healthcare fraud, waste, and abuse. The law allows authorities to pursue recoveries when false or misleading claims are submitted to federal programs.
Authorities also emphasized that reports from healthcare workers, patients, and the public can help investigators identify potential fraud. Suspected healthcare fraud, waste, abuse, or mismanagement can be reported through the HHS fraud hotline at 800-HHS-TIPS (800-447-8477).