Have a Heart

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When you hear the words, ”have a heart,” it usually refers to expressing care and compassion for those less fortunate. Cardiologists are doctors who ”have a heart” for those with heart ailments and strive to repair cardiac issues so patients can hopefully live a long and relatively healthy life. The website, NorthJersey.com reports on a doctor, who used thousands of his patients to bill for $19 million in fraudulent claims – possibly the largest amount of fraud by a single practitioner in the area. (What a heartless act. There’s nothing empathetic about stealing benefits from people with heart conditions.)

The story details the case of a 69-year-old cardiologist with an impressive resume. His distinguished career included founding multiple medical services companies in New York and New Jersey, as well as holding a teaching position at Columbia University. Did I mention he had a Ph.D. in physics?

According to court records, the cardiologist spent more than $6 million in advertising on Spanish-language television and radio stations to draw patients into his practice, where he and others ordered diagnostic tests that were not needed. He ran a ”medical mill” over an eight-year period and diagnosed a majority of his Medicare and Medicaid patients with coronary artery disease and angina, while prescribing extensive treatments – even though they did not suffer from these ailments. So, who paid for all of these services? (You guessed it – false claims were submitted to Medicare, Medicaid and insurance companies for services that were not needed.) In all, the doctor billed Medicaid and Medicare more than $75 million for his services.

The doctor pleaded guilty to health care fraud, as well as Social Security fraud. Where does the Social Security fraud come in? He kept his wife on the payroll, allowing her to collect $263,000 in benefits to which she was not entitled. (Got to love a guy who plays all the angles.) He will serve six-and-a-half years in prison, three years of supervised release and was ordered to pay $19 million in restitution.

It’s ironic, the heart doctor didn’t show any compassion for taxpayers when he was bilking us out of millions of dollars, but I bet he was hoping for a bit of compassion from the judge. The doctor is about to learn what criminals already know: prison isn’t for the faint of heart.

Source: Today’s ”Fraud of the Day” is based on the article titled, ”Closter Cardiologist Sentenced to 6 ½ Years for Fraud,” written by Rebecca D. O’Brien and published on NorthJersey.com on November 20, 2013.

NEWARK – A prominent cardiologist who pleaded guilty this year to health care fraud was sentenced Wednesday at federal court in Newark to 6½ years in prison.

Dr. Jose Katz, 69, of Closter had enjoyed a distinguished career. Born in Cuba, he obtained a college degree and a Ph.D. in physics by the age of 23. He founded and ran medical services companies in New York and New Jersey and held a teaching position at Columbia University. He and his wife raised three children.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.