Dive Brief:

• A federal grand jury has indicted a physician for allegedly ordering unnecessary ultrasounds, percutaneous allergen tests and nerve transmission tests for Medicare patients.

• The allegations cover six counts of healthcare fraud, each of which carries a maximum sentence of up to 10 years in prison.

• The Department of Justice (DOJ) shared details of the case the day before an audiology practice paid $566,000 to settle allegations that it falsely billed the government for tests it performed.

Dive Insight:

It has been a busy week for healthcare fraud cases. Early this week, DOJ revealed a federal grand jury in Chicago had indicted Omar Garcia, the aforementioned physician, who the indictment said approved a range of tests despite knowing they were not medically necessary.

Garcia and others then allegedly played a role in the submission of fraudulent claims for Medicare payments. Prosecutors said these payment requests came from multiple medical entities, a fact they said represents an attempt to minimize scrutiny by ensuring that no single company billed the government a noticeably large sum.

Once Medicare reimbursed the companies, the physician was allegedly paid via checks "reflecting his percentage of the payments." Prosecutors claim Garcia's activities took place between 2011 and 2015.

As it stands, arraignment is yet to be scheduled and the physician is presumed innocent. If the government proves Garcia guilty in the anticipated court case, he could receive a sentence of 10 years in prison for each of the six counts of alleged healthcare fraud.

The day after releasing details of the indictment, DOJ revealed it had settled a case with an audiology practice in New York. The practice, Oviatt Hearing and Balance, admitted that it offered "improper inducements" such as gift cards to Omaha Steaks, the opportunity to win a free iPad, and Butterball turkeys to beneficiaries of federal healthcare programs. That admission covers various occasions from July 2011 to January 2018.

Oviatt also admitted to allowing two unlicensed, unsupervised individuals to perform audiology tests on various days from January 2016 to November 2016. The audiology practice billed these services to Medicare and TRICARE, a military health program, "as though they had been rendered by a licensed provider."

As part of the settlement, Oviatt admitted to those activities and agreed to $566,263 to resolve the case.