DEER PARK, N.Y. (CBSNewYork) – Long Island’s largest radiology practice was forced last week to pay a multi-million dollar settlement after two local women exposed years of fraudulent billing practices.
The settlement was announced after Zwanger-Pesiri Radiology plead guilty to criminal health care fraud.
One of the whistleblowers spoke exclusively to CBS2’s Carolyn Gusoff.
“I was going up against a Long Island giant,” said whistleblower Linda Gibbs.
Gibbs said she she would not have come forward if not for bullet proof evidence.
“I would do it again,” she added. “My face is not blacked out because I am not ashamed, nor am I proud. It’s the right thing to do.”
Gibbs started at Zwanger-Pesiri in 2010 and quickly suspected something wasn’t adding up.
For years, Gibbs said, patients who came in for one type of x-ray or ultrasound were automatically signed up for a second, unnecessary test.
Gibbs claims that Dr. Steven Mendelsohn, chief executive officer of the practice, falsified claims for tests performed by non-credentialed doctors and had the staff intentionally spread tests out over different days.
In one such case, Gibbs said he made an elderly woman come back four separate times for four separate x-ray tests, one for each hand and one for each wrist.
Exposing abuses such as this requires courageous insiders like Linda, according to Washing D.C. attorney Tim McCormack.
“She knew she would be ostracized,” said McCormack. “She knew she would have a hard time getting a job, but she knew this was the right thing to do.”
He added that this kind of fraud is hard for the government to find on their own. Luckily, Gibbs, along with the second whistleblower, directed authorities to where the records were kept.
An attorney for Zwanger-Pesiri says that “the company has admitted no wrongdoing of any kind,” and that “these inquiries were never about the failure to perform billed services, nor did they concern the quality of our services.”
As part of a government incentive to encourage whistleblowers to come forward, the two former Zwanger-Pesiri employees will receive a percentage of the $10 million settlement, roughly $200,000 each.
For Gibbs, it was never about the money.
“When you see something wrong,” she says, “have enough nerve to stand up for it.”
CBS2 reports that as part of the settlement, Zwanger-Pesiri has agreed to undergo federal billing oversight for five years. The practice sees 800,000 patients a year.
See below for a full statement regarding the settlement from Zawnger-Pesiri:
“Zwanger & Pesiri Radiology Group LLP has reached a settlement agreement with the U.S. Department of Justice, the New York Attorney General and the Department of Health and Human Services, Office of Inspector General. This resolution settles enforcement matters pursued by these parties relating to certain billing practices of the company that the government maintained were not justified under prevailing regulations. The settlement was made in compromise of disputed claims, and the company has admitted no wrongdoing of any kind in reaching this resolution.
“We are pleased to put these investigations behind us, which is in the best interests of our company and our patients. It is important that our patients know that these inquiries were never about the failure to perform billed services, nor did they concern the quality of our services, which continue to be the gold standard in radiological care,” the company said.
We want to thank all of our entrusted patients and loyal referring physicians throughout Long Island, Eastern Queens and the New York Metropolitan area who have continued to put their faith, trust and confidence in us. This past year we have seen 800,000 patients from over 5,000 different physicians. We thank each and every one of you, individually and collectively.
We also are glad to be able to continue our Tzedakah by providing completely free radiology services for the indigent residents of Long Island. This effort totals approximately $2million annually, and over $12 million since the inception of our program.
We remain committed to maintaining the absolute highest quality of care by offering the most advanced and fastest MRI units, the first outpatient clinical PET/MRI in the country, same day scheduling appointments for every type of examination and the quickest report turnaround times anywhere.
Again, we just want to thank all Long Islanders for their continued faith, trust and confidence in us. We most definitely will continue doing our very best to serve you.”