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N.y. man defrauds medicare of $70,000 in medical devicereimbursements - China Hydraulic Pump System by vacuumse mse





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N.y. man defrauds medicare of $70,000 in medical devicereimbursements - China Hydraulic Pump System by
Article Posted: 07/16/2012
Article Views: 93
Articles Written: 1079
Word Count: 380
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N.y. man defrauds medicare of $70,000 in medical devicereimbursements - China Hydraulic Pump System


 
Business,Business News,Business Opportunities
BOSTON – Michael McKay, 32, of Saratoga Springs, N.Y..pleaded guilty in district court on May 11 for forgingphysician"s chart notes to make Medicare or private carrierclaims qualify for reimbursements for bone growth stimulatormedical devices. According to the Office of the Inspector General (OIG), between2008 and 2010, McKay collected $70,000 in false Medicare claims. [See also: Sebelius, Holder put spotlight on fight against Medicare fraud .] District Judge Denise Casper has scheduled McKay"s sentencingfor Sept. 6, 2012.

McKay faces up to 10 years in prison, to befollowed by three years of supervised release; a $250,000 fine;asset forfeiture and restitution. Had the case proceeded to trial the government"s evidencewould have proven that between 2008 and 2009 McKay was a territorymanager for a company that manufactured and distributed bone growthstimulator medical devices, according to the OIG. McKay"sterritory included New York, Pennsylvania and Ohio. The device that McKay sold was intended to assist patients withbone fractures that did not heal properly, according to the OIG.Medicare has specific guidelines describing when it will pay forthis device for one of its beneficiaries.

Many private insurancecarriers follow these guidelines as well. McKay often receivedorders for patients that did not satisfy these guidelines. Whenthis happened, McKay forged the patients" medical records tomake it appear as though the order met Medicare or private payerguidelines. McKay altered physician"s chart notes, changing the dates ofpatient visits and inserting false diagnoses, officials from theOIG said.

McKay also created phony medical chart notes, describingpatient visits that did not occur. [See also: CMS targets fraud with new analytics .] The medical device company fired McKay after it discovered hisfraud, OIG officials said. After that, McKay"s supervisor andanother territory manager, Derrick Field, concocted a scheme inwhich McKay continued to submit orders from doctors in his formerterritory, but he submitted them through Field. Field, who was also convicted for healthcare fraud in a similarscheme, submitted the orders to the device company and split thecommissions with McKay. McKay continued to forge patients"medical records even after he was fired by the company for thisconduct, according to the OIG.

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