UPDATE | Ashland cardiologist sentenced to 5 years in prison

Ashland cardiologist Dr. Richard E. Paulus has been sentenced to five years in prison for performing unnecessary heart procedures in Kentucky.
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ASHLAND, Ky. (WSAZ) -- UPDATE 5/2/19 @ 8:25 p.m.
A cardiologist convicted of performing unnecessary heart procedures was sentenced Thursday to five years in prison, according to a U.S. District Court official in Kentucky.

Dr. Richard E. Paulus, 71, also has been sentenced to three years supervised release and ordered to pay $1.1 million in restitution to Medicare, Medicaid and other private insurers. He also was ordered to pay a $1,100 special assessment fee.

Paulus was convicted of performing unnecessary heart procedures and falsifying records to make the procedures appear necessary before billing insurers. Investigators say the procedures were performed at King's Daughters Medical Center.

Investigators say between 2006 to 2012, Paulus billed Medicare for more heart procedures than any other cardiologist in Kentucky and was fifth in the country for the amount paid by Medicare for stent procedures.

His conviction was initially overturned before an appeals court ruled last June to overturn a judge's acquittal of Paulus.



UPDATE 7/10/18 @ 11:30 p.m.
The health care fraud conviction of a Kentucky doctor accused of performing unnecessary heart procedures has been reinstated.

The Lexington Herald-Leader reported Tuesday that an appeals court's June ruling has overturned a judge's acquittal of cardiologist Richard E. Paulus. The ruling reinstated an October 2016 jury conviction on 11 charges.

Paulus was accused of performing unnecessary heart procedures and falsifying records to make the procedures appear necessary before billing insurers. In March 2017, a federal judge ruled that prosecutors didn't prove beyond a reasonable doubt that Paulus had "acted with fraudulent intent."

That judge ordered a new trial, but the appeals court said that decision wasn't adequately justified. It sent the case back to him for further consideration.

Paulus' lawyer says he'll keep seeking an acquittal.



UPDATE 4/5/17 @ 3:55 p.m.
ASHLAND, Ky. (WSAZ) -- A federal court has appealed the motion for a new trial for an Ashland cardiologist, court records show.

Last month, Dr. Richard E. Paulus was acquitted of several counts of a conviction that he had performed unnecessary heart procedures on dozens of patients.

Paulus was scheduled to be sentenced April 25, but that was cancelled and a motion for a new trial was granted.

Paulus was accused of performing numerous medically unnecessary heart procedures during a five-year period and falsifying records in order to bill Medicare, Medicaid and private insurers. He is the namesake of the heart center at King's Daughters Medical Center in Ashland.

The federal notice of appeal was filed in U.S. District Court in Ashland.



UPDATE 3/7/17 @ 9:30 p.m.
ASHLAND, Ky. (WSAZ) -- An Ashland cardiologist convicted last fall of performing unnecessary heart procedures on dozens of patients will be getting a new trial, according to federal court records.

Dr. Richard E. Paulus was acquitted of several counts.

He was scheduled to be sentenced April 25, but that has been cancelled and a motion for a new trial was granted.

Following his conviction on Oct. 27, 2016, Paulus said substantial legal errors were committed in his trial, including the jury being given incorrect instructions.

In court documents, Paulus also accused prosecutors of using misleading evidence, including a settlement with the Kentucky Board of Medical Licensure.

Paulus was accused of performing numerous medically unnecessary heart procedures during a five-year period and falsifying records in order to bill Medicare, Medicaid and private insurers.

Paulus is the namesake of the heart center at King's Daughters Medical Center in Ashland where the procedures were performed.



UPDATE 11/23/16 12:30 p.m.
ASHLAND, Ky. (AP) – A Kentucky doctor convicted of performing unnecessary heart procedures on dozens of patients is asking for a new trial.

The Daily Independent reports Ashland cardiologist Dr. Richard E. Paulus says substantial legal errors were committed in his trial, including the jury being given incorrect instructions.

Paulus was convicted Oct. 27 on charges of health care fraud and making false statements relating to health care matters.

In court documents, Paulus also accused prosecutors of using misleading evidence, including a settlement with the Kentucky Board of Medical Licensure.

Paulus was accused of performing numerous medically unnecessary heart procedures over a five-year period and falsifying records in order to bill Medicare, Medicaid and private insurers.

Paulus, who faces 25 years in prison, is scheduled to be sentenced on April 25.



UPDATE 10/28/16 @ 4:30 p.m.
ASHLAND, Ky. (WSAZ) – Dr. Richard Paulus, a cardiologist and namesake of the heart center at King's Daughters Medical Center, is now convicted of health care fraud. Other heart doctors tell us Dr. Richard Paulus put lives at risk by giving them heart stents when they weren't needed.

"It's just a sad day for medical care when something like this happens,” said Dr. Mark Studeny. “It taints the honor and respect and humility that we as physicians trying to take care of patients the best we can, puts a black eye on our profession."

It’s damage done from a man supposed to be saving lives.

A heart stent is a metal mesh device used to prop open a coronary blockage.

Federal authorities say Paulus put heart stents in more than 70 patients who didn't need them, then falsified their records so he could bill the government and insurance.

"It wouldn't surprise me that there are actually more,” said Studeny. “That's just the ones they used for the trial."

Government entities like Medicare and private insurance companies will only pay for procedures which are deemed medically necessary. For a heart stent, it requires a patient to have an artery which is at least 70 percent blocked plus symptoms.

Dr. Studeny is the chairman of the cardiovascular department of Marshall University’s School of Medicine as well as the lab director of the St. Mary’s Medical Center Cath Lab. He saw some of the Paulus' patients.

On a number of occasions, he found those stents weren't needed. Studeny was one of 10 cardiologists to testify in court.

"You're doing patients harm and you're trying to make money," he said.

In Studeny’s mind, it makes Paulus no better than doctors who push pills.

Getting a stent is no easy thing. Except for people who have had a heart attack, Studeny said it has not been proven to give you a longer life. It means new medications and an increased risk of later complications, even an heart attack.

"We don't put stents in without significant forethought and making sure that the appropriate patients that will have more benefits than harm by the procedure."

That's why, while it's never easy to testify in a trial, especially against a fellow physician, in this case, Studeny was comfortable being a witness for the prosecution.

"Putting a stent in gives a patient a different disease process for lack of a better term," he said.

The Paulus name is still on the Heart Center. Paulus sold his practice to King's Daughters Medical Center in 2008 and retired five years later in 2013.

King's Daughters settled with the federal government for $40.9 million in 2014, though they admitted no wrongdoing. They declined to be interviewed for this story but they released a statement, expressing sadness by the verdict and hope for a successful appeal by Paulus.

We have their full statement on the sidebar to this story.

Studeny said he was a little surprised to hear that they are still standing behind him.

Paulus now faces 20 years in prison for the health care fraud charge and five years for making false statements.

His attorney Robert S. Bennett declined to be interviewed but released a statement. “Obviously we were very disappointed with the jury verdict. We think respectfully that they were wrong. There are several motions pending before the court. Based on that, we might appeal. People have to remember it’s a marathon not a sprint.”

Of all the doctors in the country from 2006 to 2012, Paulus billed Medicare the fifth highest amount for heart stents. According to the Dartmouth Atlas of Health Care, Ashland physicians conducted a stent procedure on an average of 27 out of every 1,000 Medicare enrollees in 2010, more than 3.5 times the national average. In a report by Bloomberg.com, King’s Daughters did 28 percent more stent-related procedures in 2011 than any other Kentucky hospital.

The guilty verdict for Paulus came down after a trial last seven weeks. He's scheduled to be sentenced in April 2017.

A civil lawsuit against Paulus and King’s Daughters by some patients is still ongoing. An attorney representing some of the plaintiffs tells us it is currently in the discovery phase.



ORIGINAL STORY 10/28/16
COVINGTON, Ky. (WSAZ) -- An Ashland cardiologist has been found guilty on charges that he billed Medicare, Medicaid and private insurers for heart procedures that were medically unnecessary.

Richard Paulus was found guilty of health care fraud and making false statements relating to health care matters.

According to a release from the Kentucky Department of Justice, evidence was presented that from 2008 to 2013, Paulus performed numerous invasive heart procedures on patients who didn't need them.

Paulus falsified patients' medical records to make it appear the procedures were necessary and qualified for payment.

He was convicted of placing unnecessary coronary stents and performing unnecessary catheterizations in patients.

According to the evidence, Paulus placed stents in over seventy patients whose blockages were significantly less than 70 percent – in
some cases very little blockage at all; but Paulus recorded them at or near 70 percent in the records, in order to get paid for the procedures.

From 2006 to 2012, Paulus billed Medicare for more heart procedures than any other cardiologist in Kentucky and was number 5 in the nation in terms of amount paid by Medicare for stent procedures.

Paulus is scheduled to be sentenced on April 25, 2017.

He faces a maximum of 20 years for health care fraud and up to five years for making false statements.

A statement from King's Daughters Medical Center is attached to this story.

Other WSAZ stories on Richard Paulus are also attached.

In May of 2014, King’s Daughters Medical Center agreed to pay the U.S. Government $40.9 million to resolve civil allegations that it made millions of dollars by falsely billing federal health care programs for performing medically unnecessary heart procedures on patients.

Keep checking WSAZ Mobile and WSAZ.com for the latest information.



 
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