Spokane cardiologist Dr. Romeo Pavlic agreed Tuesday to pay $300,000 to settle a federal lawsuit alleging he overbilled Medicaid and Medicare for tests he did not perform on developmentally disabled patients at Lakeland Village in Medical Lake.
Pavlic, who is affiliated with multiple hospitals, including Deaconess Hospital and Providence Holy Family Hospital, has been practicing in the Spokane area since 1980.
“When doctors exploit vulnerable patients and bill for procedures that were never performed, they violate the basic trust that patients and taxpayers extend to healthcare providers,” said Steven Ryan, of the U.S. Department of Health and Human Services Office of Inspector General, in a news release. “We will continue to aggressively pursue those who engage in health care fraud.”
According to court documents, Pavlic would conduct “cardiac clinics” at Lakeland Village where once a month he would bill for “services not provided or tests not conducted.” For instance, Pavlic continually billed for echocardiograms, which use high-frequency waves to make pictures of the heart and its arteries so that doctors can detect potential problems, when instead he provided other “limited” tests.
He continued the “false” billing practices even after he received a written warning from federal regulators in December 2012, according to the federal government. During this time he and his wife, Dorothy, filed for bankruptcy claiming they owed about $161,000 to the Internal Revenue Service for unpaid taxes for 2010 based on personal debts.
Pavlic was not available for comment Tuesday night when the settlement was announced, and his attorney, Mark Vovos, did not respond to messages Tuesday seeking comment.
As part of the settlement, Pavlic did not admit wrongdoing.
While the settlement did not disclose whether Pavlic will retain his medical license, the government did reserve the right to pursue any criminal liability and to audit Pavlic or his companies and business records, at any time.
The case surrounded Pavlic’s care that he provided at Lakeland Village, which serves about 250 patients who have “profound mental and physical disabilities.”
The facility was the subject of 40,000 violations discovered during an inspection in 2013. When another surprise inspection in January 2014 discovered another 21 violations, federal officials from the federal Centers for Medicare and Medicaid Services threatened to cut funding.
However, those officials backed away from their threat in 2015 after the Washington state Department of Social and Health Services responded by improving many of the conditions that led to the complaints.
It was during this time, between Jan 1, 2010, and Dec. 31, 2013, that Pavlic was providing the cardiac clinics under the businesses Cardiovascular Institute, PC, Cardiovascular Institute II, PC, and USA Heart, Inc., according to court records.
The case was investigated by Assistant U.S. Attorney Tyler Tornabene and the settlement approved Tuesday by Acting U.S. Attorney Joseph Harrington. Of the settlement amount, some $279,190 will be paid to the federal government and $20,810 will go to the state.
“This settlement agreement resolves some very serious allegations very favorably for the taxpayers,” Harrington said in a news release. “Doctors, especially those providing services to our most vulnerable citizens, must not violate their duty to the taxpayers who are funding those needed services. If doctors do violate that duty they can expect, at a minimum, to pay back the taxpayers much more than they took.”
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