A married couple from Rockaway, N.J., was sentenced Tuesday to more than six years in federal prison for forging physicians signatures and receiving more than $4.8 million from Medicare and private insurers for diagnostic tests and reports that were never interpreted by a licensed physician, according to the Department of Justice.
Kirtish N. Patel, 54, and Nita K. Patel, 53, were sentenced to 100 and 78 months in prison, respectively. Both defendants pleaded guilty before U.S. District Judge William H. Walls to separate indictments charging them each with one count of healthcare fraud.
According to court documents, from 2006 through June 2014, Mr. and Ms. Patel owned and operated mobile diagnostic testing companies called Biosound Medical Services and Heart Solutions of Parsippany, N.J., which were approved Medicare providers. The companies provided various diagnostic tests, including ultrasounds, echocardiograms and nerve conduction studies that are used to diagnose heart defects, blood clots, abdominal aortic aneurysms and other serious medical conditions.
Biosound technicians conducted diagnostic testing at primary care physicians' offices in New York and New Jersey, and the company was responsible for sending the tests to a "reading physician" who would interpret the results. After the reading physician prepared a report, Biosound was responsible for providing it to the referring physician.
Mr. Patel admitted to fraudulently interpreting and writing diagnostic reports produced by Biosound from October 2008 to June 2014, despite not having a medical license and knowing the reports would be used by the referring physicians to inform patient treatment decisions. Ms. Patel admitted to assisting her husband in forging physician signatures on the fraudulently produced reports to make them appear legitimate, according to the DOJ. They both also admitted to falsely indicating to Medicare 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, according to the DOJ.