Thursday, December 10, 2015

U.S. Attorney’s Office Files Civil Qui Tam Lawsuit Against New Jersey Couple And Two Diagnostic Companies For Falsifying Diagnostic Test Reports And Failing To Properly Supervise Tests

Medicare and OIG have targeted diagnostic companies for the past five years. There has been an increase in whistleblower and false claims cases involving diagnostic companies as well.

On November 19, 2015, the government intervened in a False Claims Act lawsuit and filed a complaint against a New Jersey couple and their diagnostic imaging companies for knowingly submitting false claims to Medicare for thousands of falsified diagnostic test reports and the underlying tests. This followed the owners' guilty pleas to health care fraud relating to the qui tam claims in the civil lawsuit.

Nita K. Patel and Kirtish N. Patel of New Jersey were and/or are owners and operators of Biosound Medical Services Inc. and Heart Solution PC. The Patels pleaded guilty November 17, 2015, to health care fraud charges set forth in an Information related to this conduct.

The civil complaint alleges that the Patels and their companies:
(1) created fraudulent diagnostic test reports, 
(2) forged physician signatures on these reports, and 
(3) billed Medicare for the fraudulent reports and the underlying tests that were used solely to create these reports. 

The civil complaint alleges that defendants billed Medicare for neurological tests that they conducted without the required physician supervision. The complaint also alleges that defendants knowingly submitted false claims for neurological tests conducted without physician supervision.

The lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act. The Act allows private citizens with knowledge of fraud to bring civil actions on behalf of the government and to share in any recovery. The False Claims Act also permits the government to intervene in such lawsuits, as it has done in this case. 

The civil case is captioned U.S. ex rel. Jane Doe v. Heart Solution, PC, et al., No. 14-3644 (D.N.J.). With the criminal plea, there may be summary judgment issues and there will probably be negotiations on criminal restitution and civil settlement since the cases are related.

Posted by Tracy Green, Esq.


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