Modern Vascular accused of pressuring doctors for more referrals in Medicare fraud
The U.S. Department of Justice has accused a chain of clinics, including one in Fort Worth, of defrauding the government by pressuring surgeons and radiologists to increase the number of procedures on patients.
The federal government filed a False Claims Act complaint against chiropractor Yury Gampel of Arizona and 15 of his clinics, all of which operate under the name Modern Vascular, as well as five affiliated companies he owns.
The Modern Vascular location in Fort Worth, at 5750 Stratum Drive, opened in July 2020.
In a statement, the company said the government’s complaint lacked merit and that its “business practices comply with the spirit and the letter of the law.”
Modern Vascular operates at least 15 endovascular clinics throughout the U.S., all of which focus on treating peripheral arterial disease. The disease is caused by plaque buildup that reduces the flow of blood from the heart, according to the National Institutes of Health. It most commonly affects the legs and can cause cramping and numbness. In some cases, PAD can cause gangrene or require a leg or foot to be amputated. It is usually treated through medicines and lifestyle changes, and can sometimes require a surgery called angioplasty to open the artery.
The complaint comes after a 2021 investigation by the news organization Searchlight New Mexico. Modern Vascular patients in Arizona and New Mexico told the news organization they had been given unnecessary treatments so that the company could collect more money from insurance companies. The disease can affect people with Type 2 diabetes, and is more common in older adults.
The federal government has also alleged that Modern Vascular clinics bribed local physicians to refer patients by offering the opportunity to invest in the company. Before opening a clinic in a new market, the government alleges, Gampel would seek local physicians and offer up to 2% ownership interest in the clinic. These physicians were required to continue referring patients to retain their investment in the company, according to the complaint.
The company denied this accusation. It said in its statement that “no investor of Modern Vascular has ever received a payment based on the volume of referrals while disregarding Modern Vascular’s multiple compliance safeguards.”
The government’s complaint accuses the company of defrauding the Medicare and Tricare health insurance programs. The government has paid the company more than $50 million in insurance claims to Medicare Part B and TRICARE, according to the complaint.
The False Claims Act, under which the complaint was filed, is the federal government’s primary tool to prosecute healthcare fraud. If the whistleblowers and the federal government are successful in their case, Modern Vascular could be responsible for paying back up to three times the demonstrated losses to the government. The company had not filed a legal response as of Dec. 30.
The government, including the FBI, has been investigating Modern Vascular for at least two years. Modern Vascular said in a statement that it has cooperated with the investigation and provided thousands of documents.
Are you a current or former patient at Modern Vascular Fort Worth? Have you worked with the clinic as a health care provider? Tell us about your experience. You can contact health reporter Ciara McCarthy at cmccarthy@star-telegram.com or call or text 817-203-4391.
This story was originally published December 30, 2022 at 1:47 PM.
