Between 2009 and 2011, Excela Health’s Greenburg Hospital allegedly performed unnecessary cardiac stent procedures, and officials from the U.S. Department of Health and Human Services investigated the case, according to TribLive News. Although Excela Health reimbursed the federal government nearly $2 million in Medicare payments this past July, the Justice Department prohibited Excela from releasing the terms until the government made it public earlier in December.

Two cardiologists, Dr. George BouSamra and Dr. Ehab Morcos, submitted reimbursement claims for cardiac stent procedures that patients didn’t need. Both physicians were employed by Westmoreland County Cardiology, and the investigation revealed that some of the patients who underwent the procedure did not have significant plaque buildup that would justify a coronary stent. The cardiologists are both facing pending medical malpractice lawsuits in Westmoreland County.

Excela self-reported the possible overstenting and overbilling, prompting independent experts to review the procedures performed by the two cardiologists. Excela CEO Robert Rogalski explains that the company proactively dealt with the issue: “We were aware of the situation, we investigated, we self-reported, and Excela believes that was an important factor in resolving the issue.”
This past summer, another medical corporation was investigated for allegedly performing unnecessary cardiac services at ten of its Florida hospitals to boost revenues and profit margins. Some doctors at Hospital Corporation of America (HCA), the nation’s largest for-profit hospital chain, were not able to justify cardiac procedures that they performed.

A former nurse at one of HCA’s hospitals, the Lawnwood Regional Medical Center, wrote a troubling letter about how doctors were putting patients’ lives at risk by performing unnecessary heart procedures. Investigators found that about 1,200 cardiac catheterization procedures, which are invasive diagnostic tests, were done on patients without significant heart disease. Although HCA has hospitals in almost 20 states, Florida provides about 20 percent of the company’s revenue because of its older population.

Since the investigation, Excela has made improvements and was the first in the state to receive national accreditation for its cardiac catheterization laboratory. With the surge of overstenting and overbilling cases this year, Maryland’s state General Assembly passed legislation that mandates external peer review of coronary stent placement in an effort to help hospitals avoid costly Medicare claims denials and improve patient safety.