Radiology Firm Will Pay $10.5M in Penalties, Restitution

HealthLeaders Media News, November 18, 2016

Zwanger & Pesiri pleaded guilty to whistleblower allegations of systemic Medicare and Medicaid fraud.

Zwanger & Pesiri Radiology Group, LLP, Zwanger Radiology P.C., and Steven Mendelson, MD, have pleaded guilty to Medicare and Medicaid fraud, Attorney General Eric T. Schneiderman and United States Attorney Robert L. Capers announced earler this week.

The firm will pay more than $8.1 million in civil damages to settle allegations plus another $2.4 million in criminal restitution as part of a guilty plea to a criminal charge of healthcare fraud.

The investigation into Zwanger's billing practices began after two billers, known as "relators," filed suit under provisions of the state and federal False Claims Acts.

They alleged that the practice routinely performed unnecessary and excessive testing, and split testing into multiple appointments for financial gain.

In addition, the firm falsified the identity of rendering radiologists for services performed by uncredentialed physicians, and charged for services not performed, stated Constantine Cannon, LLP, the law firm representing the whistleblowers.

As a result of the investigation prompted by the relators' allegations, the Federal Bureau of Investigation and U.S. Department of Health & Human Services' Office of Inspector General raided Zwanger's Lindenhurst offices in 2014.

The settlement resolves allegations spanning from 2003 to 2015.

The state will pay a relator's share of $221,802 after full payment by the defendants. New York State's share of the total settlement is $1,232,236.

"These defendants knowingly overbilled Medicaid by millions, draining the program of important resources meant to help some of our most vulnerable individuals," said Schneiderman.

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