Antoine Adem, M.D., 49, of Festus, MO, and his company, Midwest Cardiovascular, Inc., were sentenced December 20. Dr. Adem was sentenced to a prison term of 45 days and ordered to pay restitution of $149,199 and a fine of $55,000 for his involvement in a healthcare fraud scheme. Midwest Cardiovascular was sentenced to a term of probation of 3 years and ordered to jointly pay restitution with Dr. Adem of $149,199 and a fine of $120,000. Midwest Cardiovascular has offices in Festus and Farmington, Missouri. Dr. Adem and Midwest Cardiovascular appeared today in federal court before U.S. District Judge Audrey G. Fleissig. Both previously entered guilty pleas on August 20, 2019. According to court documents, from January 2014 to December 2018, Dr. Adem and Midwest Cardiovascular submitted or caused to be submitted numerous false and fraudulent claims to Medicare and Missouri Medicaid. The reimbursement claims falsely indicated that Dr. Adem performed two vein procedures, known as vascular embolization and occlusions, on patients on two different days, when he actually performed the two procedures on the same day. As a result, Dr. Adem and Midwest Cardiovascular received approximately $2000 more per patient than they would have received if they had informed Medicare and other insurers that the two procedures were performed on the same day. As a result of these fraudulent claims, Medicare and Missouri Medicaid paid Dr. Adem and Midwest Cardiovascular $149,199 more than they were entitled to receive.
Dr. Adem and Midwest Cardiovascular also entered into a civil settlement agreement with the United States and have paid $1.2 million. The civil settlement resolves allegations that Dr. Adem and Midwest Cardiovascular violated the civil False Claims Act by submitting fraudulent claims to Medicare, including claims that failed to comply with Medicare regulations, claims for office visits that were upcoded, and claims that falsely indicated that surgical services for vascular embolization and occlusion were provided on two separate days. The civil settlement includes the dismissal of a qui tam complaint that was filed by whistleblower Elaine Taylor, a former employee of Midwest Cardiovascular.
