20 Years for Ohio Cardiologist Sentenced in $29 Million Overbilling Scheme
Thursday, December 24, 2015
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health LawAssistant U.S. Attorney Carole S. Rendon, said of a Westlake, Ohio cardiologist sentenced to 20 years in prison on Friday, December 18, 2015, "This defendant used his medical license as a license to steal." Dr. Harold Persaud was convicted earlier this year of one count of health care fraud, 13 counts of making false statements and one count of engaging in monetary transactions in property derived from criminal activity. From 2006 to 2012, Dr. Persaud was found to have performed unnecessary catheterizations, tests and stent insertions, and to have caused unnecessary coronary bypass surgeries as part of an overall scheme to overbill Medicare and other private insurers by $29 million. He was successful in stealing approximately $5.7 million of the total amount sought. A hearing to determine restitution has been scheduled for January 27, 2016.To read the full press release issued by the U.S. Department of Justice (DOJ) and for a full listing of Dr. Persaud's activities in furtherance of the scheme according to court documents and trial testimony, click here.
A Violation of Trust Between Doctor and Patient.According to court documents and trial testimony, Dr. Persaud performed several unnecessary tests and procedures on patients providing no medical benefits and increasing the risk of harm to his patients. Stephen D. Anthony, special agent in charge of the FBI's Cleveland office, stated, "Persaud violated the sacred trust between doctor and patient...to line his pockets. He ripped off taxpayers and put patients' lives at risk." Evidence revealed the egregious nature of Dr. Persaud's scheme, going so far as to improperly refer patients for coronary artery bypass surgery when there was no medical necessity for such an invasive procedure to be performed. Dr. Persaud was greatly benefited though by increasing the amount of follow-up testing he could perform and subsequently bill for. While two decades in prison might seem like a hefty penalty to some, U.S. Attorney Rendon, further commented on Dr. Persaud's sentencing, stating, "He [Dr. Persaud] inflated Medicare billings, falsified cardiac care records and [performed] needless sometimes invasive tests and procedures. This prison sentence is well deserved."
It's Not Worth It.While you may live the high life for some time, you will eventually be discovered and often land yourself in prison, barred from federal health care programs or taking on an exorbitant amount of debt for restitution. The government is serious about combating health care fraud. False claims are a growing problem costing the government billions of dollars each year, and the government is not shy about striking back. Punishments for defrauding the system can be quite severe.Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG)-Chicago Region, made a statement regarding this case denoting it as a "toxic mixture of fraud at the expense of patient safety and well-being and taxpayers' dollars." He further stated, "The OIG, along with our law enforcement partners, will continue to identify, investigate and seek the criminal prosecution of those who choose to exploit federally funded health care programs and the patients these programs serve." Click here for information directed at physicians regarding how to best avoid fraud and abuse in government health care programs. Due to the extreme nature of health care fraud cases, the government encourages immediate action to be taken if you are aware of fraudulent activity. Furthermore, if you are faced with allegations of fraud or abuse in violation of any government health care anti-fraud laws, you need to immediately seek advice and representation of an experienced health attorney.
Have you been suspected of health care fraud? Do you have questions or concerns regarding your current billing practices?
Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare Issues Now.The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620.
Sources:Kennedy, John. "Ohio Cardiologist Gets 20 years in $29M Insurance Scheme." Law360. Portfolio Media Inc.: 21 Dec. 2015. Web. 22 Dec. 2015.Office of Public Affairs. "Ohio Cardiologist Sentenced to 20 Years in Prison for Overbilling Medicare and Others of $5.7 Million for Unnecessary Procedures." Press Release. Justice News. Department of Justice: 18 Dec. 2015. Web. 23 Dec. 2015.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 1996-2015 The Health Law Firm. All rights reserved.
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