A US-based cardiologist has lost an appeal against a decision to refuse him permission to practice on the island after it was found he tried to mislead the Bermuda Medical Council.

Asad Qamar applied to work in Bermuda but was refused by the BMC after it expressed “troubling doubt and apprehension” about his character.

Dr Qamar went to the Supreme Court in a bid to quash the decision and argued that the BMC had judged him on unproven accusations.

But Puisne Judge Shade Subair Williams said in a February 2 judgment that Dr Qamar’s failure to mention either the revocation of his Medicare privileges or penalties imposed by the Florida State Department of Health in his application was enough to uphold the rejection.

Mrs Justice Williams said: “The saga of the claims, the resulting Medicare/Medicaid bans, the FDOH complaint and the resulting settlement in disciplinary penalties all culminated in a tremendous financial and reputational fall for the appellant.

“It is far from believable that the appellant would have omitted to disclose any one of these facts due to any oversight.”

Dr Qamar founded the Institute of Cardiovascular Excellence in Florida in 2009, which became one of the largest cardiovascular practices in the US.

The institute had 24,000 patients by 2012 and had become the largest beneficiary of cardiovascular reimbursements by Medicare in Florida.

But Dr Qamar and ICE were accused in 2015 of billing Medicare and Medicaid for unnecessary procedures and improperly waiving co-pays after claims were made by two whistle blowers.

Dr Qamar denied any wrongdoing, but he and ICE received a three-year federal ban from Medicare privileges and a 20-year state ban from Medicare privileges in Florida.

He appealed the bans, but settled the cases in 2016 in the face of financial struggles.

The settlement – which allowed the Medicare bans to continue – did not contain any admission of liability by Dr Qamar or ICE, or any concession by the government that its claims were not well founded.

Dr Qamar said in an affidavit: “The decision to settle was made for purely practical and commercial reasons and not because I accepted that I was in the wrong.”

The Florida State Department of Health also launched an investigation into Dr Qamar to determine if disciplinary action was required.

Dr Qamar and FDOH reached a settlement in September 2018 where a letter of concern was attached to his doctor’s licence and he was fined $5,000.

The settlement did not come into force until February 2019.

The court heard Dr Qamar sold ICE to the University of Florida in 2017 and continued to practice medicine in the state until 2019, although the Medicare ban meant that much of his work was unpaid.

Dr Qamar applied for permission to practice in Bermuda in October 2018 with the intention of operating a cardio-cath lab on the island.

In his application form, he indicated that no disciplinary action had been taken against him by a medical authority, and that he had not had his privileges in a hospital or healthcare facility denied, revoked or restricted.

Dr Qamar told the court he denied the first question because when he filled out the form in October 2018 no disciplinary action had been taken and that it was not until February 28, 2019 that a letter of concern was added to his file.

He said he denied the second question because he believed it referred to “hospital or other healthcare facility privileges”.

Dr Qamar said: “At no point was I trying to conceal or hide information.

“I deeply regret that my truthful answers to these questions have been interpreted and characterised as half-truths that were designed to mislead the respondent.

“That was never my intention. I am an honest man.”

The court heard the only disputed element in the case was that of character and that his qualifications and professional experience were not in question.

Sam Stevens, who represented Dr Qamar, said the committee had judged his client based on unproven facts and that the allegations in Florida were baseless.

He added that Dr Qamar was never convicted of any criminal offences or any civil wrongs, and the BMC’s decision should be overturned.

But Shakira Dill-Francois, for the BMC, said Dr Qamar’s “omissions” in his application were enough to raise concerns.

Mrs Justice Subair Williams found that Dr Qamar had received disciplinary action when his Medicare services were suspended in 2015, so he had answered that question dishonestly.

She added that Dr Qamar also had a duty to disclose his pending administrative penalties.

Mrs Justice Subair Williams said: “Approximately one month prior to the submission of Dr Qamar’s application form, he had agreed terms of settlement of the Federal Department of Health’s Administrative Complaint.

“This was not finalised by the Florida Medical Board until the final order was made on February 28, 2019 – Dr Qamar knew this but sought to take advantage of the fact that he could escape disclosing this on the basis of a technical truth.

“While a ‘no’ response was just accurate, it was also undeniably misleading.”

Mrs Justice Subair Williams found that Dr Qamar had also been dishonest with his response to the question about having privileges revoked as the revocation of Medicare privileges was “plainly relevant and applicable”.

She added that in court, Dr Qamar said he had obtained legal advice about his intended answers on the application form.

Mrs Justice Subair Williams said: “Dr Qamar took calculated steps in furtherance of his ultimate aim to dishonestly conceal this relevant information from the BMC.

“I had the advantage of assessing Dr Qamar’s oral evidence during which he said that he initially expected to be interviewed after submitting the initial two-page application form. According to him, he anticipated a subsequent opportunity to more fully explain his background.

“However, I do not accept that Dr Qamar ever intended to volunteer the fuller picture of his disciplinary penalties and Medicare/Medicare privilege suspensions.”

She ruled that Dr Qamar’s conduct amounted to dishonesty, which was serious enough to dispel the “otherwise arguable case” that he was of good character.

Mrs Justice Subair Williams said that, in the circumstances, she could see no reason to overrule the BMC decision.