NEWARK, N.J. – A Rockaway husband and wife who owned a mobile diagnostic testing company collected almost $4.4 million from Medicare and insurance companies for diagnostic testing and reports that were never interpreted by a real doctor, said U.S. Attorney Paul Fishman.
Nita Patel, 53, and Kirtish Patel, 53, pleaded guilty today, before U.S. District Judge William Walls in Newark federal court, to charges of healthcare fraud, said Fishman in a press release.
The Patels owned Biosound Medical Services and Heart Solutions of Parsippany, said Fishman. "These were mobile diagnostic companies and approved Medicare providers that provided mobile diagnostic testing, including ultrasounds, echocardiograms and nerve conduction studies used to diagnose heart defects, blood clots, abdominal aortic aneurysms and other serious medical conditions," said the statement.
According to authorities, Biosound technicians would go to doctors' offices in the region to conduct diagnostic testing. Biosound was supposed to send the tests to a specialist who was supposed to interpret the results. Biosound was also supposed to provide the analyzed report to the referring physician, said Fishman.
"Biosound was paid millions of dollars by Medicare and other payers for the diagnostic testing, the reading physician’s interpretation of the results and the reports," he added.
Kirtish Patel admitted he fraudulently interpreted and wrote diagnostic reports from October 2008 through June 2014 "despite having no medical license and knowing that the reports would be used by the referring physicians to make important patient treatment decisions," said the U.S. Attorney.
He said Nita Patel admitted she helped her husband forge physician signatures on the fake reports to make them appear legitimate. "The Patels also admitted falsely representing to Medicare that the neurological testing performed by Biosound was being supervised by a licensed neurologist," said Fishman.
He said that more than half of the diagnostic reports generated by Biosound between October 2008 and June 2014 were never actually reviewed or interpreted by a physician. The Patels collected nearly $4.4 million from Medicare and private insurance companies and used the money "for personal expenses, including multiple residences and luxury vehicles," said Fishman.
The Patels face up to 10 years in prison and $250,000 fines, or twice the gross gain or loss from the offense. Sentencing is scheduled for March 15, 2016.
Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Richard Frankel in Newark, and the U.S. Department of Health and Human Services – Office of the Inspector General, under the direction of Special Agent in Charge Scott Lampert, with the investigation leading to today’s pleas.
Fishman noted he "reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses."
He said his office, since 2010, recovered more than $640 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug, and Cosmetic Act and other statutes.