Georgia Urology Practice to Pay $14M to Settle Alleged Healthcare Fraud Scheme

ATLANTA — A Georgia-based urology practice and its lead physician have agreed to pay $14 million to settle allegations they billed federal healthcare programs for procedures that were either unnecessary or never performed.

Dr. Jitesh Patel, Advanced Urology, Inc., and affiliated companies reached the settlement to resolve claims brought under the False Claims Act and the Georgia False Medicaid Claims Act.

Federal investigators allege the practice billed Medicare, Medicaid, and other government healthcare programs for a wide range of improper services, including procedures that were not medically necessary and, in some cases, not performed at all.

According to the allegations, the practice engaged in several questionable practices, including implanting medical devices without determining patient need, performing invasive diagnostic procedures unnecessarily, and routinely ordering excessive testing. Investigators also allege the practice billed for a more complex surgical procedure while performing a simpler one to receive higher reimbursement.

The investigation began after two whistleblowers, including a former employee and a physician, filed complaints alleging systemic fraud within the organization. Under federal law, whistleblowers are eligible to receive a portion of recovered funds and will collectively receive nearly $3 million from the settlement.

Authorities emphasized that such schemes not only defraud taxpayers but can also put patients at risk by subjecting them to unnecessary medical procedures.

The case was investigated by multiple agencies, including the FBI, the U.S. Department of Health and Human Services Office of Inspector General, the Georgia Attorney General’s Medicaid Fraud Division, and the Department of Veterans Affairs Office of Inspector General.

Officials noted that the settlement resolves allegations only, and there has been no determination of liability.