N.J. couple pleads guilty to fraudulent diagnostic testing for heart defects and other conditions
A New Jersey couple pleaded guilty to one count apiece of healthcare fraud and admitted to receiving more than $4.3 million from Medicare and private insurance for fraudulent diagnostic testing.
Nita K. Patel and Kirtish N. Patel, of Rockaway, N.J., owned and operated Biosound Medical Services and Heart Solutions from June 2006 through June 2014. Biosound, based in Parsippany, N.J., provided mobile diagnostic testing such as ultrasounds, echocardiograms and nerve conduction studies to diagnose heart defects, blood clots, abdominal aortic aneurysms and other medical conditions.
According to court documents, Medicare and private insurers paid Biosound millions of dollars for diagnostic testing, coordinating with physicians to interpret the results and preparing reports.
Of the diagnostic reports Biosound generated between October 2008 and June 2014, more than half were never reviewed or interpreted by a physician. Medicare and private insurers paid the Patels more than $4,386,133.75 for fraudulent reports. The documents said the couple used the money to buy multiple houses, luxury vehicles and other items.
Despite having no medical license, Kirtish Patel admitted he fraudulently interpreted and wrote diagnostic reports from October 2008 through June 2014. He said he knew referring physicians would use the fraudulent reports when making treatment decisions. Nita Patel admitted she assisted her husband by forging physician signatures to make them seem legitimate. The couple also admitted that they lied to Medicare when they said a licensed neurologist supervised Biosound’s neurological testing.
The Patels are scheduled to be sentenced on March 15, 2016. The maximum potential penalty for the healthcare fraud charge is 10 years in prison and a $250,000 fine or twice the gross gain or loss from the offense.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.