By Kathy Chaffin
kchaffin@salisburypost.com
KANNAPOLIS ó A physician assistant who served as president of a health-care practice here has surrendered his license to the N.C. Medical Board.
Christopher John Caggiano, who lives in Concord, pleaded guilty in federal court on Oct. 8 ó along with Cannon Family Medicine ó to four counts of health-care fraud. Each count carries a maximum possible penalty of 10 years in prison, up to a $250,000 fine and up to three years of supervised release, according to a press release from the U.S. Department of Justice.
Sentencing is scheduled for Feb. 11, 2009.
Investigators believe Cannon Family Medicine submitted false claims to private insurance companies, federal employee health programs, Medicare and Medicaid, the release said. Caggiano was accused of ordering unnecessary tests for some patients and billing patients’ insurance companies for tests not performed.‚
In one of the four cases, for example, the parent of a minor child ó a daughter ó took her to Caggiano for treatment of a high fever in July 2004, according to allegations presented to the N.C. Medical Board on Feb. 28, 2008. Caggiano ordered blood work, X-rays and an antibiotic treatment and told the girl’s mother to bring her back for a follow-up visit in nine days.
When the parent brought the daughter back for the follow-up visit and requested the results of her blood tests, Caggiano’s staff informed the parent that unless the daughter “submitted to a complete physical and pap smear,” he would not see her. The parent refused to consent to the exam and pap smear, and they left the office.
Later, the patient’s insurance company submitted a statement indicating Caggiano had billed the company for $3,009 for two office visits. The statement reflected that allergy tests were given to the patient on days she was not in his office and included a charge of $360 for a drug test the patient’s parent did not consent to or have knowledge of being performed.
In another case in which a patient went to see Caggiano for shoulder pain, he ordered X-rays, an MRI (magnetic resonance imaging) diagnostic test, blood work, an EKG (electrocardiogram), nerve conduction studies, allergy testing as well as other tests, according to allegations presented to the state medical board. When she returned for a scheduled follow-up visit in two weeks, she was told she would have to have a pap smear to receive her test results.
The patient refused and left the practice to see another physician about her shoulder pain. He diagnosed her with a torn rotator’s cuff and told her she needed immediate surgery. The physician expressed alarm about Caggiano’s unnecessary testing and contended it was wrong for the patient not to be told of the results of her tests.
The patient’s insurance provider was billed more than $2,000 for the services rendered by Caggiano. The extensive laboratory testing “was not medically indicated or justified,” according to the allegations.
In July 2006, the N.C. Medical Board suspended Caggiano’s license to work as a physician assistant for two years, but the suspension was to be stayed on Jan. 1, 2007, and Caggiano was to remain on probation for the duration.
The complaint investigated by the medical board also alleged the physician assistant violated professional standards by allowing patients to refer to him as “Dr. Caggiano.”
“The medical records produced by Mr. Caggiano consistently failed to document or demonstrate detailed medical histories and physical examinations sufficient or adequate for the extensive laboratory and diagnostic testing ordered for each patient,” according to the finding released in July 2006 by the medical board.
“As a result of the extensive laboratory and diagnostic testing, (the patients’) health insurance providers incurred significant costs,” the finding continued.
The board filed a separate complaint in 2006 against Dr. John Barr, a Cleveland doctor responsible for supervising Caggiano’s work. That year, Barr accepted a reprimand from the medical board.