Arizona doctors settle claims involving medically unnecessary vein ablation procedures.
A cardiology practice in Arizona and three physicians have agreed to pay $4.75 million to settle federal allegations that they performed vein procedures that were not medically necessary. Federal officials announced the agreement as part of a civil case brought under the False Claims Act, which allows the government to recover money when federal healthcare programs are billed for services that do not meet required standards.
The settlement involves Tri-City Cardiology, P.C., a physician group located in the Phoenix metropolitan area. According to federal authorities, the case centers on vein ablation procedures that were allegedly performed even though patients did not meet accepted medical guidelines for the treatment. Vein ablation is a procedure used to close veins that are not functioning properly, often to treat conditions such as chronic venous insufficiency or painful vein disorders in the legs.
Investigators said the procedures at issue involved perforator veins, which are small blood vessels that connect deeper veins in the leg to veins closer to the skin’s surface. Medical guidelines state that treatment of these veins is only appropriate under certain conditions. When those conditions are not present, the procedure may not be considered necessary medical care.
Federal officials alleged that three physicians working with the practice—Dr. Jaskamal Kahlon, Dr. Joshua D. Cohen, and Dr. M. Joshua Berkowitz—performed vein ablations on perforator veins even though patients did not qualify for the treatment under accepted standards. The government claimed that the procedures occurred between January 2017 and April 2022.
Authorities also alleged that medical records were altered or documented in ways that made the procedures appear justified. According to investigators, patient files sometimes included measurements or descriptions that suggested the treatment met medical guidelines, even though those details were inaccurate. Officials said the records included information about vein size, the length of abnormal blood flow, patient symptoms, and whether patients had attempted other treatments first.
In many cases involving vein conditions, doctors are expected to try conservative care before performing an ablation. Conservative care may include lifestyle changes, compression stockings, or other non-surgical methods designed to relieve symptoms. Federal investigators alleged that documentation related to these efforts was sometimes inaccurate or incomplete in the medical records reviewed during the investigation.
Government officials stated that federal healthcare programs such as Medicare only pay for procedures that meet recognized medical standards. When unnecessary procedures are billed to these programs, public funds may be spent on care that patients did not actually need. Authorities said such billing can reduce the money available for other treatments that are considered appropriate and necessary.
The case was handled through a joint effort between the Justice Department’s Civil Division and the United States Attorney’s Office for the District of Arizona. Investigators from the Department of Health and Human Services Office of Inspector General also assisted in the investigation. These agencies often work together in cases involving alleged healthcare fraud or improper billing practices involving federal programs.
Officials noted that the False Claims Act remains one of the government’s main tools for investigating suspected healthcare fraud. The law allows the government to pursue financial recovery when medical providers are accused of submitting false or misleading claims for payment. In many cases, settlements allow disputes to be resolved without a trial while returning funds to the government.
Federal representatives said the case highlights concerns about situations where financial interests may influence medical decision-making. They stated that healthcare providers are expected to place patient care above profit and ensure that procedures are supported by proper medical evaluation and documentation.
The settlement resolves the allegations but does not include a determination that the defendants violated the law. Agreements of this type often allow both sides to conclude a case without admitting liability while still addressing concerns raised during the investigation.
Authorities continue to encourage individuals with information about suspected healthcare fraud to report concerns to federal investigators. Tips from patients, healthcare workers, and other sources often help investigators identify cases where billing practices may not follow program rules.
Federal officials stated that enforcement efforts remain focused on protecting public healthcare programs and maintaining trust in medical services funded by taxpayer dollars. The case involving Tri-City Cardiology reflects ongoing oversight of billing practices within the healthcare system and the government’s efforts to recover funds when questions arise about the necessity of certain medical procedures.
Sources:
Arizona Cardiology Group to Pay $4.75M to Resolve Allegations of Unnecessary Vein Ablations
Tri-City Cardiology, Phoenix doctors to pay $4.75M for alleged unnecessary procedures
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