A federal jury in Baltimore has convicted interventional cardiologist John R. McLean, of Salisbury, Md., on six healthcare fraud offenses in connection with a scheme in which McLean submitted insurance claims for inserting unnecessary cardiac stents, ordered unnecessary tests and made false entries in patient medical records to defraud Medicare, Medicaid and private insurers.
In 2008, McLean and the provider in which he practices, Pennisula Regional Medical Center (PRMC) in Maryland, were sued by patients and their families on 13 charges of negligence.
“The evidence shows that McLean egregiously violated the trust of his patients and made false entries in their medical records to justify implanting unneeded cardiac stents and billing for the surgery and follow-up care,” said U.S. Attorney for the District of Maryland Rod J. Rosenstein.
“Placing unnecessary stents in the hearts of patients is a crime of unthinkable proportions,” said Nicholas DiGiulio, special agent in charge for the U.S. Department of Health and Human Services' Office of Inspector General. “We will continue working to bring to justice those who practice greed rather than good medicine."
According to evidence presented at his two-week trial, McLean had a private medical practice known as John R. McLean M.D. and Associates in Salisbury.
From as early as 2003 to May 2007, McLean performed cardiac catheterizations and implanted unnecessary cardiac stents in more than 100 patients at PRMC, according to the prosecutors. He then falsely recorded in the patients’ medical records the existence or extent of coronary artery blockage observed during the procedures in order to justify the stent and the submission of claims to healthcare benefit programs, including Medicare and Medicaid.
In addition, McLean ordered that his cardiac patients, including those that received stents, undergo a battery of medically unnecessary follow-up tests such as cardiolite stress tests, echocardiograms and EKGs. McLean submitted claims for the unnecessary stents and testing that were paid by healthcare benefit programs, including Medicare and Medicaid.
McLean faces a maximum sentence of 10 years in prison for healthcare fraud and five years in prison on each of five counts of making false statements relating to healthcare matters. U.S. District Judge William D. Quarles, Jr. scheduled sentencing for Nov. 10.
The government also is seeking forfeiture of $711,583, believed to be the proceeds of the scheme, but the Judge will determine the exact amount of forfeiture at sentencing.
Earlier this month, the Maryland State Board of Physicians revoked the medical license of interventional cardiologist Mark G. Midei, MD, due to his “repeated and serious” violations of the Medical Practice Act, including “unnecessary stent insertions,” and the falsification of patients’ medical records—both of which the board deemed “indefensible.” With the same case, the hospital where Midei practiced, St. Joseph Medical Center in Townson, Md., settled with patients and patient families for $22 million. Midei is still embroiled in the legal battle, but the U.S. Senate has faulted him for "questionable" stenting and his relationship with Abbott.
McLean's conviction was announced by Rosenstein; DiGiulio; and Special Agent in Charge Richard A. McFeely of the FBI.