A Salisbury cardiologist accused of placing unneeded coronary stents in hundreds of patients has been indicted by a federal grand jury in Baltimore on health care fraud charges alleging he put patients' lives at risk unnecessarily while billing private and public insurers millions of dollars.
John R. McLean, 58, who surrendered his medical privileges at Peninsula Regional Medical Center in 2007 after a hospital investigation, is charged with one count of fraud and six counts of making false statements to insurers and patients, whose records he allegedly falsified. If convicted on all counts he could face up to 40 years in prison.
The indictment, announced Wednesday, marks at least the second time in two years that a physician in the United States has faced the potential of federal prison for placing inappropriate stents, following the case of a Louisiana doctor who was sentenced to 10 years in 2009.
And it is a case that echoes in the Baltimore area, where Towson cardiologist Mark G. Midei faces similar allegations of performing inappropriate procedures.
Midei is accused of performing as many as 585 unnecessary stent procedures during his last two years of practice at St. Joseph Medical Center. He has denied the allegations, and no criminal charges have been filed against him, though he faces multiple civil suits from former patients and possible professional sanctions by state regulators. His attorneys have said in court filings that the allegations could lead to criminal charges.
"Dr. Midei has many professionals who support his conduct," an attorney for Midei, Stephen L. Snyder, said Wednesday. "By necessity, Dr. Midei's story has yet to be told. It will, however, be told in the very near future."
In McLean's case, investigators at his Salisbury hospital alleged in 2007 that he had placed at least two dozen coronary stents in the arteries of patients who didn't require them. But federal investigators later found more than 200 such cases, according to court documents from an earlier federal investigation into McLean, and identified hundreds of unneeded electrocardiograms, echocardiographs and nuclear stress tests as well.
The indictment claims that from 2003 to early 2007, McLean falsified patients' records to make it appear they needed procedures and lied on various claim forms. In addition to the criminal charges, the indictment seeks the forfeiture of $519,000 in cash and two properties.
"The indictment charges that Dr. McLean egregiously violated the trust of this patients and made false entries in their medical records to justify implanting unneeded cardiac stents and billing for the surgery and follow-up care," Maryland U.S. Attorney Rod J. Rosenstein said in a statement.
McLean's attorney, Richard W. Westling, said in a statement that his client was "saddened" by the charges.
"The government's allegations amount to little more than second-guessing Dr. McLean's medical judgment and seeking to apply the after-the-fact judgment of prosecutors and federal agents in place of those of the treating physician," Westling said. "We will vigorously defend this case at trial and are confident that Dr. McLean will be vindicated."
McLean has reimbursed more than a dozen patients and their insurers for stents that he conceded were medically unnecessary, according to court records. He has also suggested that poor eyesight was to blame for his medical miscalculations.
But federal agents — and former patients who have filed civil lawsuits against him — say it was about money. Stent procedures can cost more than $10,000 apiece.
Natalie Vowell, an investigator from the U.S. Department of Health and Human Services, estimated in related court filings that McLean's inappropriate procedures defrauded Medicare, funded by taxpayers, of nearly $2.2 million, with most of the amount going to the hospital.
Officials at the Salisbury hospital declined to comment Wednesday, but in related civil court filings, the hospital says it generally denies liability "for each and every allegation."
St. Joseph has also denied allegations against it in legal filings, though the hospital has said it's willing to accept financial responsibility "where the individual claim has been fully assessed and determined to have merits."
The state's Board of Physicians, which oversees doctors, has charged Midei with "gross overutilization of health care services" and "willfully making a false report or record in the practice of medicine," among other violations of state law.
Snyder, who is representing Midei in his fight to keep his medical license, said regulators were "receptive" to Midei's side of the story at a confiddential meeting held last month to discuss the allegations.
No sanctions have been taken against Midei, whose medical license is still in good standing, according to online records. So is McLean's license. He renewed it once since the since the first allegations against him surfaced in 2007, and it now expires in 2011.