Vijay Patel ran a diagnostic testing company.
Vijay Patel, a Parsippany, New Jersey resident and his diagnostic testing company are being sued by the US government for knowingly submitting false claims to Medicare for thousands of diagnostic testing services that were not done, U.S. Attorney Paul J. Fishman announced Tuesday.
Patel, 59, of Parsippany, owner and operator of Mobile Diagnostic Testing of Parsippany, pleaded guilty Dec.15, 2014, to health care fraud related to this conduct, reported Daily Record.
The civil complaint filed Tuesday alleges Vijay Patel violated the False Claims Act. According to the complaint: Patel had an associate who was a cardiologist and also a participant in the Medicare program.
From around 2009 through 2012, the cardiologist’s Medicare contractor had placed him on so-called “pre-payment review,” which was initiated to ensure that the doctor was submitting claims within established rules and regulations, and which required him to submit documentation, including medical records, to support the services being billed to Medicare, according to the Justice Department.
Under pre-payment review, claims for reimbursement that did not have the documentation necessary to support the services being billed are rejected by the Medicare contractor.
From August 2011 through December 2012, Patel and the cardiologist defrauded Medicare by submitting claims to Medicare for diagnostic testing services that the doctor had performed in December 2010 through September 2012, enabling him to evade Medicare’s pre-payment review.
Patel submitted the cardiologist’s claims through his company and his brother’s company, Biosound Medical Services Inc. (Biosound), as if Mobile Diagnostic and Biosound had performed the services instead of the doctor. The fraudulent claims sought more than $2.8 million in reimbursement money for services they did not provide.
Once Patel received the Medicare reimbursement money paid to the two companies for diagnostic testing services the cardiologist had performed, Patel transferred a portion of the payment to the doctor and kept a substantial portion for himself.
Patel’s brother and the brother’s wife – Kirtish N. Patel, 54, and Nita K. Patel, 53, of Rockaway, were sentenced earlier this year to more than six years in prison for receiving more than $4.8 million from Medicare and private insurance companies for diagnostic testing and reports that were never interpreted by a licensed physician, reported Daily Record.
Kirtish and Nita Patel were also ordered to forfeit $4.8 million, pay restitution of $4.8 million. A civil judgement further ordered them to pay the United States $5 million in damages and $2.75 million in civil monetary penalties.