Evidence also proved that 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. In another aspect of the fraud, O’Lear 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. Similarly, O’Lear falsely billed for taking multiple images or views of patients when only one view had been done, thereby requiring a greater reimbursement.
During an audit by a Medicaid MCO, O’Lear covered up the scheme and committed aggravated identity theft by creating false medical records, including forms for ordering x-rays and radiology reading reports. He even falsified x-ray images, but was found to have re-used the same image repeatedly as different images of the same patient and even 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.
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As a result of the scheme, court documents state that 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.
“Nobody needs X-rays after they’re dead, and the taxpayers shouldn’t have to pay for them,” Ohio Attorney General Dave Yost said. “This crook made victims of everybody who pays taxes, and he deserves every day of his sentence.”
This case was investigated by the United States Department of Health and Human Services, Office of the Inspector General (HHS-OIG), the Cleveland FBI and the Ohio Attorney General’s Healthcare Fraud Section . This case was prosecuted by Assistant U.S. Attorneys Elliot Morrison and Brendan O’Shea.Back to HCB News