WASHINGTON (Diya TV) – Kirtish and Nita Patel, a New Jersey couple who owned a mobile diagnostic testing company, have been ordered to pay nearly $8 million in fines for their parts in committing multi-million dollar healthcare fraud. Medicare fraud can be committed in a variety of ways that leads to more public money getting in the hands of these fraudsters. Expanding your knowledge on the topic can help you spot and whistleblow these bad actors. If you’re interested in learning more go to websites such as Lawyer.com (https://www.lawyer.com/a/how-fraudulent-providers-game-medicare-and-medicaid.html).
The two are alleged to have created fraudulent diagnostic test reports, according to the government’s civil complaint. They forged physician signatures on the reports, then billed Medicare for the doctored reports, the complaint said. They also billed Medicare for neurological tests that they conducted without the required physician supervision, the Justice Department added. When it comes to Medicare, there may be people out there who are not as familiar with this as some might be. With this being said, it may be worth it to do some research into Understanding Hospital Fraud: The Types & Abuses. Even getting to grips with the basics is better than not know anything at all, especially if this could help anyone out in this situation.
The lawsuit was filed under the whistleblower provisions of the False Claims Act, which allows private citizens with knowledge of fraud to bring civil actions on behalf of the government and to share in any recovery. For reporting the acts, the whistleblower will receive 15 to 25 percent of the $7.7 million recovered by the government for bringing the misconduct to their attention.
The False Claims Act also allows the government to intervene in such lawsuits.
According to documents filed in court and statements made in open court, from 2006 through 2014, the Patels owned and operated Biosound Medical Services Inc. and Heart Solutions in New Jersey. Biosound technicians would travel to the office of a primary care physician in the New York and New Jersey area to conduct diagnostic testing.
After conducting the exams, Biosound was the responsible for sending the tests to a reading physician, an appropriate specialist who would interpret the results. After the reading physician prepared a report, Biosound was responsible for providing it to the referring physician.
Biosound were paid millions by Medicare and other entities for the diagnostic work, the reading physician’s interpretation of the results and the reports, the prosecutors said.
Kirtish admitted in court to fraudulently interpreting and writing diagnostic reports produced by Biosound, this despite having no medical license and knowing that the reports would be used by the referring physicians to make important patient treatment decisions. Nita assisted in the forgery.
The couple admitted to falsely representing to Medicare that the neurological testing performed by Biosound was being supervised by a licensed neurologist, the Justice Department said. More than half the reports filed by the company from 2008 to 2014 were never reviewed or interpreted by a physician, they added.
Nita and Kirtish were paid more than $4,386,133.75 by Medicare and private insurance companies for the fraudulent reports, which they used for personal expenses, including multiple residences and luxury vehicles, it said.