Yesterday, the Kings County District Attorney's office indicted 20 New York-area doctors for participating in a scheme to defraud Medicare, Medicaid, and other publicly funded insurance providers of approximately $146 million over three years.
The DA's press release states that recruiters would travel to low-income areas of the city and offer $30 to $40 to nearby pedestrians with Medicare or Medicaid benefits to undergo examinations at the defendants' clinics, located in Bedford-Stuyvesant, Canarsie, and Crown Heights. The recruiters themselves were paid anywhere from $30 to $50 per recruit and doctors referring to the clinics for the testing received referral fees. Once at the clinics, patients would undergo numerous medically unnecessary tests, including allergy tests, cardiograms, ultra sounds, and EMG tests, which would be billed to the insurance provider.
Included in the list of doctors are Dr. Hamid Alam (radiologist), Dr. Jeffrey Chess (radiologist), and Dr. Robert Vaccarino (cardiologist) — noted plaintiffs' physicians. Dr. Alam, specifically, was called out in the release for having been caught on tape claiming to have "fallen behind" signing off on 15,000 medically unnecessary tests. If the doctors are found guilty, they could face up to 25 years in prison.
This indictment follows on the heels of the indictment of seven other doctors in the Eastern District of New York this past summer for conducting largely the same scheme as Drs. Alam, Chess, and Vaccarino. Those doctors fraudulently billed companies more than $125 million.
While the doctors' indictment will not affect the admissibility of their medical records, it will foreclose plaintiffs' attempts to admit those records or testimony from those doctors at trial due to the risk of impeachment. Additionally, any testifying doctor's reference of the tainted records also opens the door to impeachment. This lack of non-damaging testimony regarding a plaintiff's damages gives our attorneys significant leverage when negotiating settlements with plaintiffs affected by the indictment.
Special caution should be given to any files where a plaintiff received treatment from any of the physicians or practices named in the indictment. Any special damages or liens derived therefrom should be scrutinized for accuracy and relevancy to the claimed injuries and disputed if necessary. In addition to Medicare and Medicaid, other potential publicly funded insurance providers affected in the New York metro area include: MVAIC, EPIC, ADAP, WIC, and certain workers' compensation policies.
Read the DA's full press release here.
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