PITTSBURGH (KDKA) -- A Fox Chapel cardiologist has been found guilty by a federal jury of two counts of healthcare fraud, involving more than $13 million in insurance billing.
Dr. Samirkumar J. Shah, a 56-year-old cardiologist of Fox Chapel had submitted false claims to private insurance companies including UPMC, Highmark Blue Cross Blue Shield, Gateway Health and government insurance programs Medicare and Medicaid for outpatient treatments. Shah submitted claims that totaled over $13 million and he received reimbursement payments of $3.5 million.
"Healthcare fraud is a serious problem that impacts every American," said FBI Pittsburgh Special Agent in Charge Robert Jones. "It takes critical resources from our health care system and increases health care costs for everyone. Dr. Shah's disregard for safe patient care goes against the medical ethics he was to uphold. The FBI, with its law enforcement partners, will continue to allocate a significant amount of expert resources to investigate these crimes and hold those defrauding the system accountable."
Shah had submitted claims for a treatment known as External Counter Pulsation, or ECP, which involves using a specialized bed that has pressure cuffs meant to exert pressure on patients lower extremities as a means to increase blood flow to the heart.
Shah purchased 25 of these beds and offered the ECP services to patients at locations in Western Pennsylvania, Ohio, New York and Florida.
He advertised ECP as the "Fountain of Youth" and claimed it would make patients younger and smarter. He also claimed it was a treatment for things such as obesity, migraines, high blood pressure, low blood pressure, diabetes and erectile dysfunction.
Evidence showed that Shah never reviewed the required ultrasounds patients had to undergo as a precautionary measure to rule out blood clots that could've led to a stroke or heart attack during treatment.
"Health care fraud threatens the safety and integrity of our entire health care system," said U.S. Attorney Scott Brady. "Doctors and medical professionals like Dr. Shah who issue false diagnoses, order unnecessary testing and fraudulently bill Medicare and Medicaid in effect steal from the most vulnerable in our community. Today's jury verdict sends a clear message to those who would do the same: if you commit health care fraud, you will be prosecuted to the fullest extent of the law."
Shah will be sentenced on November 6 and the law calls for a maximum of 10 years in prison, a fine of $250,000 or both.
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