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Portable Fraud

Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

O’Lear was the president of Portable Radiology Services, a company that supposedly provided portable X-ray services to individuals residing in nursing homes, skilled nursing facilities and long-term care facilities. But the reality of it was that O’Lear only provided portable fraud.

From 2013 through 2017, O’Lear submitted false claims for reimbursement to Medicare and Medicaid for thousands of x-rays and related services that he and his business did not provide, including approximately 151 x-ray services purportedly provided to patients on dates after the patients had died. Fraudsters are partial to dead people since they can’t tattle!

But dates and paperwork eventually raised questions on O’Lear. O’Lear billed Medicare and Medicaid for purportedly having provided x-ray-related services to beneficiaries at nursing facilities on dates when the beneficiaries were hospitalized and not at the facilities. O’Lear also took multiple x-rays that had all been performed in one visit and falsely claimed that each one had been done on a different day, requiring separate reimbursement for transporting the portable x-ray equipment on each date.

An audit from Medicaid found that O’Lear covered up his scheme by creating false medical records, including forms for ordering x-rays and radiology reading reports. He was found to have re-used the same image repeatedly as different images of the same patient and also as images of different patients. In creating the falsified order forms, he forged the signatures of his employees and the physician he said had ordered the x-rays.

As a result of the scheme, O’Lear submitted fraudulent bills to Medicare, Medicaid and Medicaid MCOs for approximately $3.7 million and received approximately $2 million in payments as a result of fraudulent bills. O’Lear was found guilt and on September 29, 2022, sentenced to 15 years in prison and was ordered to pay $1,989,490 in restitution to Medicare, Medicaid.

Great attention to detail by the audit teams of Medicaid and Medicare.

Today’s Fraud of the Day is based on an article “Northeast Ohio man and president of radiology services company sentenced to 15 years in prison following healthcare fraud scheme” published by WKYZ Studios on September 30, 2022

A Northeast Ohio man who was part of a $2 million health care scheme was sentenced to 15 years in prison on Thursday. 58-year-old Thomas O’Lear of North Canton was also ordered to pay $1,989,490 in restitution to Medicare.

O’Lear, the president of Portable Radiology Services (PRS) was sentenced after being convicted of defrauding Medicare and Medicaid of nearly $2 million from billing for x-ray services that his company did not provide. He also was part of a fraudulent cover-up scene to hide the crime and committed aggravated identity theft in doing so.

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