December 13, 2011
NEWARK, N.J. – Thirteen New Jersey doctors and a nurse practitioner are charged in a cash-for tests referral scheme for allegedly taking illegal kickback payments to refer patients to an Orange, N.J., medical testing facility, New Jersey U.S. Attorney Paul J. Fishman and U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) Special Agent in Charge Tom O’Donnell announced.
This morning, more than 65 federal and local agents and officers led by HHS-OIG arrested the 14 health care practitioners, to whom radiology and diagnostic facility Orange Community MRI (“OCM”) allegedly paid monthly cash kickback payments in exchange for their referral of Medicare and Medicaid patients to OCM for testing services.
The defendants arrested this morning are scheduled to appear this afternoon before U.S. Magistrate Judge Madeline Cox Arleo in Newark federal court. OCM’s executive director, Chirag Patel, 36, of Warren, N.J., was arrested on Dec. 8, 2011, in connection with the scheme. He appeared that day before Judge Arleo and was released on a $750,000 bond.
Each defendant is charged in a separate Complaint. According to the Complaints filed in the related cases:
OCM began making the illegal kickback payments as early as 2010. At the end of each calendar month, individuals at OCM printed patient reports that detailed how many diagnostic tests – including MRIs, ultrasounds, echocardiograms, CAT Scans, and dual-emission X-ray absorptiometries – were referred by each of the defendants. These patient reports were used to calculate the payment owed to each defendant.
According to each defendant’s agreement with OCM, the health care practitioners were paid kickbacks for each Medicare or Medicaid beneficiary diagnostic test referred to OCM. The defendants also were paid for referring some privately insured tests. The exact nature of the payments differed per agreement; some of the doctors were only paid for MRI and CAT Scan referrals, while other defendants also were paid for the referral of ultrasounds, echocardiograms, and dual-emission X-ray absorptiometries.
During only a two-month period between early October and early December 2011, there were 32 separate payments made to or by the 15 defendants currently charged in connection with the alleged scheme, with total cash kickbacks of $51,500.
“Selling test referrals for cash is illegal. Patients have every right to expect their doctors will recommend medical service providers because they do the best job, not because they provide the best bribes,” said U.S. Attorney Fishman. “There is no room in the federal healthcare system for those who see a person in need of care as an opportunity to make an extra buck on the side.”
“When physicians take kickbacks that influence how they practice medicine, it has the potential to taint the medical advice and care that is provided to their patients. The audacity of these physicians should offend honest taxpayers, especially at a time when our taxpayer resources are stretched thin. We will continue to aggressively pursue all angles of Healthcare fraud. We would also like to thank the Centers for Medicare and Medicaid Services (CMS) for their law enforcement support as this case was an offshoot of a CMS referral,” said Special Agent in Charge O’Donnell.
All of the health care providers charged practice in New Jersey and have offices in Newark, Orange, East Orange, West Orange or Irvington. The attached chart identifies the defendants, their office locations, and itemizes payments to or from each of the defendants – ranging from $200 to more than $5,000 per month. Other than Chirag Patel and Jose Castaneda, who is a nurse practitioner, all of the defendants are medical doctors.
Each of the health care practitioners is charged with one count of violating the federal health care program anti-kickback statute by soliciting and receiving bribes, which carries a maximum potential penalty of five years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. Chirag Patel is charged with violating the same statute by offering and paying bribes, which carries the same maximum potential penalty.
U.S. Attorney Fishman praised special agents of HHS-OIG, under the direction of Special Agent in Charge O’Donnell, for leading the investigation, and thanked CMS for its vital role at the inception of the investigation. He also thanked special agents of IRS – Criminal Investigation, under the direction of Special Agent in Charge Victor W. Lessoff, and the Union County Prosecutor’s Office, under the direction of Theodore J. Romankow, for assisting with the arrests. He added that the investigation is continuing.
The government is represented by Assistant U.S. Attorney Joseph Mack of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
The charges and allegations contained in the Complaints are merely accusations, and the defendants are presumed innocent unless and until proven guilty.