A U.S. District Court has sentenced a New Jersey couple to more than six years in prison and ordered $4.8 million in restitution after the husband and wife forged physicians’ signatures on thousands of diagnostic reports out of their two mobile diagnostic imaging companies.
The couple billed government-funded New Jersey Medicaid, Medicare and private insurance companies for the forged reports, resulting in $4.8 million in false claims, U.S. Attorney Paul J. Fishman announced Tuesday.
New Jersey Couple Forges Physician Signatures on 10,000+ Diagnostic Imaging Reports
Kirtish N. Patel, 54, and his wife Nita K. Patel, 53, pleaded guilty in November 2015 to forging physician signatures on more than 10,000 diagnostic reports and falsely representing those reports as reviewed by a licensed physician.
The couple administered ultrasounds, echocardiograms and nerve conduction tests for New York and New Jersey primary care physicians out of their two Parsippany-based mobile companies, Biosound Medical Services Inc., and Heart Solutions Inc.
Physicians use the tests performed by the Patels’ companies to diagnose potentially life threatening conditions, including blood clots, heart defects, and aortic aneurysms. Protocol requires test results be sent to a licensed outside physician for interpretation. The outside physician then signs the report and sends it back to the imaging company for delivery to the referring physician.
Kirtish Patel instead read the test results himself, despite having no medical license and understanding that vital patient treatment decisions are based on physician interpretations of test results. His wife Nita would then sign off on the reports, giving the impression that a licensed physician had interpreted the test results.
The Patels billed Medicare, Medicaid and other insurance companies for the tests, physician interpretations and reports from 2006 through 2014. Insurance programs paid more than $4.8 million for the fraudulent reports, which the Patels used for personal expenses, including multiple residences and luxury vehicles.
Both members of the Rockaway couple pleaded guilty to a single count of health care fraud each in November 2015. Kirtish Patel admitted to interpreting the diagnostic test results himself and writing the reports. Nita Patel admitted forging physician signatures.
Both also admitted they fraudulently represented their neurological testing procedures as conducted under a licensed neurologist’s supervision.
Former Biosound Employee Files Whistleblower Suit: U.S. Wins $7.75M Civil Health Care Fraud Settlement
In a related civil settlement reached in July of this year, U.S. District Judge Stanley R. Chesler ordered the Patels pay the U.S. government $5 million in damages and $2.75 million in civil monetary penalties plus interest for falsifying diagnostic test reports, forging physician signatures and failing to properly supervise neurological tests. Judge Chesler ordered the payments after granting the U.S. motion for summary judgment on the two FCA counts of a civil lawsuit filed in November 2015.
A former Biosound employee filed the initial civil lawsuit under the whistleblower provisions of the federal False Claims Act, which allows private individuals with original knowledge of false claims to sue on behalf of the government and share between 15% and 30% of any recovery.
The unnamed whistleblower in this case stands to collect between $1.2 million and $2.3 million for contributing to the $7.7 million government recovery.
Internal Medicine Doc Paresh Patel Violates Anti-Kickback Statute: Gets 12 Months Prison Time
On June 8, 2016, U.S. District Judge Mary L. Cooper sentenced a Jamesburg internal medicine physician, Paresh Patel, 55, (no relation to Kirtish and Nita Patel) to 12 months in prison and imposed a $6,000 fine for accepting over $174,000 in kickbacks from Biosound Medical Services in exchange for patient referrals. Paresh Patel pleaded guilty to violating the Anti-Kickback Statute for receiving bribes for referring patients to Kirtish and Nita Patel from September 2009 through December 2013. In return for patient referrals, Biosound paid Paresh Patel’s property tax obligations and home renovation expenses.
Judge Walls Denies Lesser Sentence Request: Kirtish Patel Refuses to Accept Responsibility
According to Assistant U.S. Attorney Danielle Walsman, Kirtish Patel said he forged the physician signatures to expedite the return of reports to referring physicians in order to “save the company.”
Patel did not send test results to an outside physician for interpretation, even when he himself was unable to interpret the results.
Nita Patel asked the Court’s forgiveness and accepted responsibility for the crime. Judge Walls sentenced Nita to 78 months in prison and three years of supervised release. Kirtish Patel, on the other hand, claimed his actions did not harm anyone and explained that he had learned how to interpret the diagnostic test results.
Without an acceptance of responsibility, Judge Walls sentenced Kirtish Patel to a harsher 100 months in prison followed by three years of supervised release. In addition, Judge Walls ordered the couple to pay $4.8 million in restitution to the government and private insurers.