By: Christopher Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, Ma.
A Health Care Provider Defense and Compliance Firm
In a stark reminder of the importance of compliance in the healthcare industry, the U.S. Attorney’s Office for the District of Massachusetts announced charges against Dr. Vishnudat Seodat, a New York-based internist, for his involvement in a fraudulent kickback scheme. Dr. Seodat allegedly conspired with a mobile diagnostic company to order medically unnecessary brain scans in exchange for cash payments, costing Medicare and private insurers approximately $1 million in fraudulent claims.
The Allegations
According to federal prosecutors, from 2013 to 2019, Dr. Seodat conspired with others to:
- Order unnecessary tests: He allegedly used false diagnoses to justify transcranial Doppler (TCD) scans, which measure blood flow in the brain.
- Receive cash kickbacks: He was paid approximately $100 per test for the hundreds of unnecessary scans ordered.
- Submit fraudulent claims: Co-conspirators billed Medicare and private insurers for these scans, exploiting the healthcare reimbursement system.
The Legal Implications
Dr. Seodat, who has agreed to plead guilty, faces:
- Up to 10 years in prison for conspiracy to commit healthcare fraud.
- A fine of up to $250,000.
- Potential additional penalties, including supervised release.
Lessons for Providers and Compliance Professionals
Healthcare fraud schemes, such as this, not only result in severe penalties but also damage the trust and reputation of those involved. Compliance professionals and healthcare providers must prioritize the following to avoid legal and ethical pitfalls:
- Implement Robust Compliance Programs: Ensure all staff are educated about anti-kickback statutes and Medicare regulations.
- Conduct Regular Audits: Review billing practices and ensure diagnostic tests are medically necessary and well-documented.
- Monitor Vendor Relationships: Scrutinize third-party contracts to ensure they comply with legal and ethical standards.
Christopher A. Parrella, Esq., CPC, CHC, CPCO, is a leading healthcare defense and compliance attorney at Parrella Health Law in Boston. With extensive experience in healthcare law, he provides robust legal support in areas including regulatory compliance, audits, healthcare fraud defense, and reimbursement disputes. Christopher emphasizes client-centered advocacy, offering one-on-one consultations for personalized guidance. His proactive approach helps clients navigate complex healthcare regulations, ensuring compliant operations and defending against government investigations, audits, and overpayment demands.
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