Cardiologist gets 6.5 years in prison for 'fountain of youth' billing scam

A cardiologist was sentenced to 6 1/2 years in prison Aug. 5 for his role in a fraud scheme involving more than $13 million in false insurance claims, according to the Pittsburgh Post-Gazette.

In addition to the prison sentence, Samirkumar Shah, MD, was ordered to pay $1.2 million in restitution. U.S. District Judge David Cercone ordered the sentence.

Shah was convicted of two counts of healthcare fraud in 2019. Prosecutors said during his trial that Shah submitted fraudulent claims to both private and government insurers for external counter pulsation, an outpatient treatment meant to increase blood flow to the heart.

Shah offered these treatments to patients who didn't need them, including those with obesity, migraines and erectile dysfunction, according to prosecutors. Shah advertised the treatment as the "fountain of youth" and claimed the treatments made patients "younger and smarter," prosecutors said.

Insurers cover external counter pulsation for patients who have disabling angina. Insurance plans also require a physician to supervise the treatment.

Prosecutors said Shah directed employees to falsify documents to indicate that all patients who received the treatment suffered from disabling angina even though they didn't and had patients undergo the treatment when he wasn't supervising it.

Prosecutors said Shah submitted $13 million in false claims to insurers for these treatments, and insurers paid $3.5 million. 

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