How did St. Joseph Medical Center get to be one of the highest-volume heart-stent operations in the state? Well, according to federal allegations in a settlement announced today by U.S. Attorney Rod Rosenstein, St. Joseph paid doctors to send patients its way. Or, in the language of the settlement, St. Joseph gave MidAtlantic Cardiovascular Associates "remuneration in excess of fair market value... in exchange for the referral of lucrative cardiac procedures..."
Kickbacks, in other words. "Kickbacks give doctors an incentive to pursue unnecessary treatments...," Rosenstein says in the press release. St. Joseph does not admit liability or wrongdoing in the settlement. But it nevertheless agreed to pay $22 million to settle the claims. Everybody knew this case was out there, but it took years to settle. That's likely because new allegations have emerged that St. Joseph's Dr. Mark Midei (formerly with MidAtlantic) implanted hundreds of unnecessary coronary artery stents.
The whistleblowers in the case were Garth McDonald and other docs at Cardiac Surgery Associates, competitors of MidAtlantic, according to the settlement. Friction between the practices goes way back and was beautifully chronicled by Geeta Anand and Ron Winslow in a 2003 Wall Street Journal piece. Here's how it begins: