Nita K. Patel, 53, and Kirtish N. Patel, 53, have pleaded guilty before U.S. District Judge William H. Walls in Newark federal court to separate information charging them each with one count of health care fraud.
The Rockaway, New Jersey, husband and wife who owned a mobile diagnostic testing company today admitted receiving more than $4.3 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.
According to the documents filed in the case and statements made in Court: From 2006 through June 2014, Nita and Kirtish 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. Nita and Kirtish Patel also admitted falsely representing to Medicare that the neurological testing performed by Biosound was being supervised by a licensed neurologist.
According to the informations, 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. Nita and Kirtish Patel were paid more than $4,386,133.75 by Medicare and private insurance companies for the fraudulent reports, which they used for personal expenses, including multiple residences and luxury vehicles.
The health care fraud charge to which Nita and Kirtish Patel pleaded guilty carries a maximum potential penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. Sentencing for both defendants is scheduled for March 15, 2016.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Richard M. 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 J. Lampert, with the investigation leading to today’s pleas.
The government was represented by Assistant U.S. Attorney Danielle Alfonzo Walsman of the U.S. Attorney’s Health Care and Government Fraud Unit. 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 $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.