Share this Article

Categories

Industry News
Go Back to Healthcare Industry News
A 4 minute read
Jun 11, 2019 11:17:20 AM

In a letter sent to former patients and friends, Dr. Joseph P. Galichia, MD, FACC, said today, 'This past week, the details of a settlement I reached with the Department of Justice after seven years of negotiations were made public. The DOJ press announcement received considerable media attention, much of which was factually inaccurate, out of context and therefore potentially damaging to patients and my colleagues.'

Dr. Galichia, a former two term president of the International Society of Cardiovascular Interventionists and former founder of the Galichia Medical Group and founder of the Galichia Heart Hospital, announced today that he is calling on Congress to investigate 'the DOJ's flawed probe, according to board certified experts based on a whistleblower's civil action and the effect that questionable legal precedents are having on cardiologists nationwide.' Dr. Galichia said that the so-called whistleblower was a disgruntled former employee who started the entire action and is not even a cardiologist.

Dr. Galichia stated, 'Unfortunately, the federal government has chosen to solve its financial problems with Medicare by pursuing physicians, hospitals, and other healthcare providers to seek reimbursement of money paid for legitimate patient care. This national trend of accusing providers seriously interferes with the patient-physician relationship and leaves many patients without the care they need because physicians and other providers are intimidated by the risk of a fraud allegation by the federal government.'

This week Dr. Galichia agreed to a $5.8 million settlement with the government rather than prolong an already seven year-long investigation which, he said, had flawed results, according to a number of highly qualified expert physicians in cardiology regarding the use of a life-saving procedure of which he was one of the pioneers in the U.S., known as balloon angioplasty with stent procedure. This procedure has been credited, in large part, with the reduction in mortality due to heart disease, the nation's leading fatal disease.

'The federal government decides, after the fact, what care the patient should have received, second-guessing the physician and the patient regardless of the health or satisfaction of the patient,' Dr. Galichia explained. 'We know that the care we have provided to our patients is precisely the care they needed. Expert interventional cardiologists who reviewed the 100 cases in this investigation unanimously agreed that our treatment was appropriate.'

Gary Ayers, counsel for Dr. Galichia, explained, 'The federal government has compounded the problem by incentivizing disgruntled whistleblowers and their lawyers to make false allegations, which the federal government then uses to extract large settlements from the providers. The government pays a physician 'expert' to second-guess another physician's medical judgment, then alleges this supposed disagreement over treatment is fraud. In Dr. Galichia's case, the government's 'expert opinion' was absolutely wrong according to four independent, board-certified interventional cardiologists who reviewed the same cases. The government's 'expert opinion' was also wrong according to the patients who received Dr. Galichia's care. Hundreds if not thousands of providers across the country have experienced this same phenomenon. Congress needs to reign in the federal government's overreaching and abusive behavior, because it puts patients at risk of not receiving the medical care they need and deserve.'

Dr. Galichia and his legal team have cooperated fully with DOJ investigators over the past seven years but, he said, 'The entire investigation simply involved too much time and expense to adequately and scientifically evaluate the substance.' Dr. Galichia summed up the allegations and the probe by the DOJ as, '…the government's baseless and relentless pursuit, plus the evolving federal court system which has made it all but impossible for expert physicians and cardiologists to counter a single expert witness paid by the federal government. Their expert is a full-time professor rather than a full-time interventional cardiologist. Critical records used in patient procedures were lost and their so-called evidence is without scientific foundation. Unfortunately, because of unrealistic legal precedents, going to court is no longer an option for innocent cardiologists across America, who are just trying to save lives.'

Excerpts from Dr. Galichia's letter:

[Dr. Galichia] firmly denies the allegations made by the 'whistleblower' and his attorney in the action just settled in the agreement with the justice department and related media coverage. [Dr. Galichia] agreed to the settlement only because, after seven years of cooperating with the investigation, the action was taking up far too much of [his] time and energy. Further, it simply became too costly to keep defending against these false accusations.

In disputing the allegations of this case, [Dr. Galichia] engaged four cardiology experts to review the cases rejected by the Government's expert. Each of the four experts holds multiple board certifications, are practicing cardiology interventionalists and have each spent time as professors at one or more medical schools. They all serve or have served as directors of their practices and their hospital's cardiology departments, conducting peer review of catheterizations for their medical staffs. They are all respected experts locally, nationally and internationally. These experts concluded that in all of the cases in question, additional review the experts determined that Dr. Galichia's treatments were medically appropriate.

OF NOTE: At least twelve of the interventions rejected by the government's expert were confirmed by intravascular ultrasound ('IVUS'). Though the hospital where they were performed could not locate the crucial IVUS film for each of the cases, the hospital did produce IVUS film for five of the interventions rejected by the government expert. In each of those cases, the objective IVUS evidence established that the treated lesion was significant, and it was medically necessary to treat it.

Settling this case is not an admission of any liability by Dr. Galichia or by his former practice, Galichia Medical Group, GMED.

Dr. Galichia has devoted his entire career to the practice of medicine and the cardiovascular care of many thousands of Americans and patients from around the world.

Dr. Galichia feels that, in his words, 'this case has been a matter of legal bullying, based on hearsay from a former GMED employee who is disgruntled over his abrupt release from his employment.'

According to Dr. Galichia, 'It is my understanding that the whistleblower will receive $1.16 million from the settlement and that he is sharing a considerable percentage of it with the attorney who represented him.'

During the seven years of diligent negotiations by and on behalf of Dr. Galichia, two federal appellate courts ruled that cardiologists cannot reasonably disagree by more than 10% to 20% about the extent of blockage in an artery. 'A precedent had been set, but it was a legal precedent, not a medical one: If a government doctor says an artery is 30% blocked, any doctor who says it's more than 70% blocked must be lying,' according to Kyle Clark and Andrew George in the Wall Street Journal, December 28, 2018.*

* 'A Second Opinion Becomes a Guilty Verdict,'

https://www.wsj.com/articles/a-second-opinion-becomes-a-guilty-verdict-11545955656.

 

 

Not a Definitive Healthcare newsletter subscriber?

Sign up to receive our latest news and blogs right in your inbox

Sign up for our newsletter

Continue Reading