Say What?

274
47600539 - stethoscope head lying on medical forms on clipboards closeup while medicine doctor working in background. health care, insurance and help concept. physician ready to examine patient

Audiologists are healthcare professionals who help individuals with hearing and balance disorders. While a Central New York audiology practice may have helped its patients with these issues, they also committed healthcare fraud by defrauding several federal health insurance programs at the same time. Read on to find out how turkeys and donuts played into the fraudulent scheme. (Say what? Yep, you heard me right.)

An estimated 38 million Americans have hearing loss issues. With the average price of a hearing aid ranging from $1,500 to $3,500 per ear, you’re looking at about two months of income. (Some people would rather lip read than pick up the tab for a new hearing aid.) Thankfully, depending on which Medicare or Tricare plan a beneficiary has, the federal healthcare programs can help defray some of the costs. (The New York audiology practice knew this, and they took advantage of it.)

The company, which has offices in Syracuse, Camillus, Manlius and Oswego, fueled their illegal healthcare fraud scheme by recruiting unsuspecting victims. They lured them in by entering Medicare and Tricare beneficiary names into a contest to win an iPad, Visa gift cards, Butterball turkeys, Dunkin Donuts and Omaha Steaks gift cards. (See, I told you there were turkeys and donuts involved. If you weren’t hungry to know more before, I bet you are now. Or, maybe you’re just hungry.) Federal law prohibits incentives to lure customers.

According to the fraud article, the government said the audiology practice employed unlicensed and unsupervised employees who performed exams on patients. (Some of those employees were actually audiology students, not certified practitioners.) Then, the company falsely billed both Medicare and Tricare for exams that were supposedly completed by professional licensed audiologists. (More than half a million dollars I might add.)

The government investigation into the New York audiology practice launched after a whistleblower lawsuit was filed by a licensed audiologist, who sold her business to the practice’s parent company and then went to work for them. (She happened to be the sister-in-law of a local Congressman. I’m sure that helped the case receive more attention.)

Well, as you can guess, the Central New York audiology business could not claim that they were hard of hearing when the charges against them were presented. The company admitted to the healthcare fraud charges and agreed to settle the case against them by paying $566,263. (That’s a lot of turkeys, donuts, steaks and iPads.) The whistleblower will receive $120,000 of those proceeds. Congratulations to the government for making their message on healthcare fraud loud and clear to any business considering carrying out a similar scheme.

Today’s “Fraud of the Day” is based on an article entitled, “Feds say CNY hearing practice used unlicensed staff to test customers,” posted on Syracuse.com on December 11, 2018.

SYRACUSE, N.Y. — A Central New York audiology practice will pay $566,263 to settle charges it provided services by unlicensed employees and offered free turkeys and other improper inducements to lure customers.

The U.S. Attorney’s Office announced the settlement today with  Oviatt Hearing and Balance LLC, which has offices in Syracuse, Camillus, Manlius and Oswego.

SHARE
Previous articleTruckin’ Along
Next articleIn the Cards
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.