On April 9, 2015, a federal grand jury in Maryland returned a superseding indictment against the owner of a Maryland-based portable diagnostic services company, charging him with an additional four counts of health care fraud resulting in serious bodily harm and death, as well as conspiracy and wire fraud, related to a scheme to defraud Medicare and Medicaid of more than $7.5 million. The company provided mostly x-ray services but also provided ultrasound tests and cardiologic examinations in Maryland, Delaware, Pennsylvania, Virginia, and the District of Columbia.
The superseding indictment contains 33 counts that allege that between 1997 and October 2013, the company’s owner, who was not a medical doctor or a licensed physician, conspired with the vice president of the company, who was a licensed radiologic technologist, and others, to defraud Medicare and Medicaid by creating false radiology, ultrasound, and cardiologic interpretation reports; by submitting insurance claims for medical examination interpretations that were never completed by licensed physicians; by falsely representing to Medicare and Medicaid, as well as to treating physicians, that the interpretations had, in fact, been completed by actual licensed physicians; and, by submitting insurance claims for radiology, ultrasound, and cardiologic examinations (and their associated costs) that were never performed, and/or which were in excess of the number of examinations ordered by the treating physician.
The superseding indictment alleges that four patients died because their x-rays were not interpreted by a qualified radiologist but rather company employees reviewed the x-ray images and failed to detect congestive heart failure, pneumonia, and a large pelvic mass revealed in the images, causing the patients to suffer serious complications and ultimately their deaths. The indictment alleges that had those x-ray images been correctly interpreted by a licensed radiologist, the medical treatment for those patients would have been different and/or their surgery avoided.
The superseding indictment further alleges that the company and its owner routinely submitted insurance claims to Medicare and Medicaid that, among other things, exaggerated the services performed by its technologists or exceeded the services ordered by the treating physician; overcharged for transportation costs; and falsely represented that the company was properly overseen by supervising physicians.
The superseding indictment seeks the forfeiture of at least $7.5 million, including two properties, luxury vehicles, bank and investment accounts, and a safe deposit box. The company’s owner faces a maximum sentence of life in prison for the conspiracy count and for each of four counts of health care fraud resulting in serious bodily harm and death; 10 years in prison for each of seven counts of health care fraud; 20 years in prison for each of eight counts of wire fraud; a maximum of five years in prison for each of 11 counts of false statements relating to health care matters; and, a mandatory two years, consecutive to any other sentence imposed, for two counts of aggravated identity theft.
If you have knowledge of acts of alleged Medicare and/or Medicaid fraud, you may be entitled to share in the proceeds of the recovery that the government receives as a result of you becoming a whistleblower and bringing the alleged wrongful billing and/or other actions to the attention of the federal government.
If you have information that may help the government recoup payments for fraudulent Medicare and/or Medicaid payments, and you wish to become a whistleblower, visit our website to complete and submit a short, secure form, or call us toll-free in the United States at 800-295-3959, to find whistleblower lawyers in your state who may investigate your whistleblower claim for you and represent you in a whistleblower lawsuit (false claims act lawsuit), if appropriate.
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