Morris County, New Jersey, Husband And Wife Sentenced To Prison For Falsifying Thousands Of Medical Diagnostic Reports As Part Of $4.8 Million Health Care Fraud Scheme
Tuesday, August 16, 2016
NEWARK, N.J. – Two Rockaway, New Jersey, residents who owned a mobile diagnostic testing company were each sentenced today to over six years in prison for receiving more than $4.8 million from Medicare and private insurance companies for diagnostic testing and reports that were never interpreted by a licensed physician, U.S. Attorney Paul J. Fishman announced.
Kirtish N. Patel, 54, and Nita K. Patel, 53, were sentenced to 100 and 78 months in prison, respectively. Both defendants previously pleaded guilty before U.S. District Judge William H. Walls to separate informations charging them each with one count of health care fraud. Judge Walls imposed the sentences today in in Newark federal court.
According to the documents filed in the case and statements made in Court:
From 2006 through June 2014, Kirtish and Nita Patel owned and operated Biosound Medical Services Inc. and Heart Solutions (collectively, “Biosound”), of Parsippany, New Jersey, which were mobile diagnostic companies and approved Medicare providers. The companies provided mobile diagnostic testing, including ultrasounds, echocardiograms and nerve conduction studies that were used to diagnose heart defects, blood clots, abdominal aortic aneurysms and other serious medical conditions.
Biosound technicians would travel to the office of a primary care physician in the New York and New Jersey area to conduct diagnostic testing. Biosound was 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 was paid millions of dollars by Medicare and other payors for the diagnostic testing, the reading physician’s interpretation of the results and the reports.
Kirtish Patel admitted to, from October 2008 through June 2014, fraudulently interpreting and writing diagnostic reports produced by Biosound despite having no medical license and knowing that the reports would be used by the referring physicians to make important patient treatment decisions. Nita Patel admitted assisting her husband in forging physician signatures on the fraudulently produced reports to make them appear legitimate. Kirtish and Nita Patel Patel also admitted falsely representing to Medicare that the neurological testing performed by Biosound was being supervised by a licensed neurologist.
More than 10,000 diagnostic reports generated by Biosound between October 2008 and June 2014 were never actually reviewed or interpreted by a physician. Kirtish and Nita Patel were paid more than $4.8 million by Medicare and private insurance companies for the fraudulent reports, which they used for personal expenses, including multiple residences and luxury vehicles.
Judge Walls also ordered Kirtish and Nita Patel to serve three years of supervised release, forfeit $4,803,875.40, and pay restitution of $4,803,875.40.
Pursuant to a civil judgment entered in July 2016, U.S. District Judge Stanley R. Chesler ordered Nita and Kirtish Patel, Biosound Medical Services and Heart solutions to pay the United States $5 million in damages and $2.75 million in civil monetary penalties.
U.S. Attorney Fishman credited special agents of the U.S. Department of Health and Human Services, Office of the Inspector General, under the direction of Special Agent in Charge Scott J. Lampert, and the FBI, under the direction of Special Agent in Charge Timothy Gallagher in Newark, with the investigation.
The government is represented by Assistant U.S. Attorney Danielle Alfonzo Walsman of the U.S. Attorney’s Health Care and Government Fraud Unit in Newark.
U.S. Attorney Paul J. Fishman 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. Since 2010, the office has recovered more than $1.31 billion 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.
Kirtish Patel: Anthony Fusco Jr. Esq. and Shay Deshpande Esq., Passaic, New Jersey
Nita Patel: Frank Arleo Esq., West Orange, New Jersey