Antoine Adem, a 49 years old doctor together with his company, Midwest Cardiovascular, Inc., were sentenced for 45 days prison term on 20th December 2019. Dr. Adem was also ordered to pay restitution of $149,199 alongside a fine of $55,000. The allegations included his involvement in a healthcare fraud scheme.
On the other hand, Midwest Cardiovascular was sentenced to a term of probation of 3 years. The company has also been ordered to jointly pay restitution together with Dr. Antonie Adem of $149,199, plus a fine of $120,000. Midwest Cardiovascular has its offices in Farmington and Festus, Missouri. The federal court arranged before U.S. District Judge Audrey G. Fleissig was arranged where Dr. Adem and his company went through the trail. The case was registered earlier this year and both, Dr. Adem and the company has entered guilty pleas on August 20, 2019.
According to the reports, it was between January 2014 to December 2018 that the two, Dr. Adem and Midwest Cardiovascular were charged with submitting numerous false and fraudulent claims to Medicare and Missouri Medicaid. As per the reimbursement claims which falsely indicated that the two vein procedures performed by Dr. Adem were done on two different dates. However, in reality, the procedures were performed on the same day.
Because of this false claim, Dr. Adem and Midwest Cardiovascular got an extra reimbursement of approximately $2000 per patient. Hence, resulting in these fraudulent claims, Medicare and Missouri Medicaid paid an extra fee of $149,199 to Dr. Adem and Midwest Cardiovascular than they were actually entitled of.
Dr. Adem and his company, Midwest Cardiovascular have entered into a civil settlement agreement with the US. As per the agreement, the two have agreed to pay $1.2 million. The civil settlement resolves allegations that were made on Dr. Adem and Midwest Cardiovascular for violating the civil False Claims Act by submitting fraudulent claims to Medicare. This further included claims that failed to abide by the Medicare regulations, the claims related to the office visits which were upcoded, as well as the claims that intentionally indicated false surgical services for vascular embolization and occlusion which never happened on two different dates.
The civil settlement also included the dismissal of a qui tam complaint. This complaint was filed by Elaine Taylor who was a former employee of Midwest Cardiovascular. Hence, according to the False Claims Act, Elaine Taylor would be entitled to have a share of the civil settlement. This amount would be a total of $240,000.
Curt Muller, the US Department Special Agent in Charge for the Office of Inspector General of Health and Human Services exclaimed, “Dr. Adem calculated that committing health care fraud was his path to riches. He was wrong, as he now pays the price for his crimes. We will continue working with our law enforcement partners to protect government healthcare programs and the taxpayer dollars on which they depend.”
This fraud case against Dr. Adem and his company was investigated by the FBI, the U.S. Department of Health and Human Services Office of Inspector General, alongside the Missouri Attorney General Medicaid Fraud Control Unit.