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A long-winded court saga has reached its final stages in the case of a prominent cardiologist accused of performing unnecessary heart procedures in order to defraud insurance companies.
Eight years after his initial federal indictment, a second jury trial for Dr. Richard Paulus will convene in United States District Court in Covington on Oct. 23.
In the re-trial, Paulus faces one count of health care fraud and 10 counts of falsifying medical records.
The lengthy legal battle included multiple appeals, overturned convictions and even a petition to the Supreme Court.
To recap:
In 2016, a jury in Covington found Paulus guilty of performing unnecessary stent placements and diagnostic catheterizations and falsifying medical records to perform them after a multi-week trial and four days of deliberation — resulting in a five-year sentence for Paulus.
The following month, Paulus’s defense team filed an appeal of the verdict and requested a new trial based on the prosecutor’s allegedly presenting misleading evidence along with other legal errors.
In March 2017, U.S. District Judge David L. Bunning ruled to vacate the verdict and acquitted Paulus after finding the U.S. failed to prove their claim that Paulus falsified statements or acted with fraudulent intent.
That ruling was eventually overturned, Paulus went to prison and was released in 2020 after Paulus’s conviction was reversed by the U.S. 6th Circuit of Appeals based on outstanding evidence — meaning Paulus would have to be re-tried.
In April 2022, Paulus petitioned the highest court in the land for a dismissal — which was denied by the Supreme Court, leading to his current legal standing and pending re-trial.
A pre-trial conference was held on Sept. 22 where it was ruled 100 potential jurors would convene for selection on Oct. 23.
According to online court filings, the battle concerning the exclusion of certain evidence is still ongoing.
Specifically, the prosecution is urging Bunning to reconsider his previous ruling to exclude certain evidence — including Paulus’s prior testimony and KDMC emails that supposedly depict Paulus’s and KDMC’s intent to garner money in exchange for the procedures.
The court previously ruled Paulus’s previous testimony could mislead or confuse the jury but the government argued there is no “unfair prejudice” in using Paulus’s own words about the events that transpired more than a decade ago.
The government also wishes to use previous emails between various KDMC personnel to present the sheer volume of cath labs conducted by Paulus and show KDMC’s “obvious financial incentives.”
In addition, prosecutors asked the court to reconsider its ruling to exclude evidence pertaining to Paulus allegedly performing so many procedures that he fell asleep in the cath lab and requested employees talk to him during procedures to prevent him from dozing off.
The defense argues Paulus’s alleged lethargy in no way indicates his intent to defraud the federal government or private insurers, adding the court’s previous ruling to omit this evidence was appropriate.
The defense has since subpoenaed billing information for stent and catheter procedures from the top 25 Medicare providers nationally, in Kentucky and in the tri-state area from 2006-12 to aid in Paulus’s defense strategy.
In addition to the top 25 providers, the defense also requests Medicare billing information from the government’s twelve expert witnesses — the majority of them specializing in cardiology to determine their “cath-to-stent ratio.”
Paulus retired from King’s Daughters Medical Center after a seemingly successful career in 2013.
At one time, the heart and vascular center at KDMC was named after Paulus, who was described in a former article as “beloved.”
In a region plagued with cardiovascular disease, according to previous reports, Paulus left his staff cardiologist position at the Texas Heart Institution in Houston to build up a cardiovascular unit that locals ordinarily would have no access to.
The argued genuine demand turned towards the alleged volume of unnecessary procedures in 2014 when two civil complaints — containing nearly 500 plaintiffs — were filed against KDMC and Paulus, claiming they underwent “medically unnecessary and harmful cardiac procedures.”
Two months after the initial filings in Boyd County, KDMC paid out a $40.9 million settlement to the U.S.
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