Zwanger-Pesiri Radiology Will Pay $8 Million in Medicaid Fraud Reclamation

Zwanger-Pesiri Radiology will pay more than $10 million in a settlement over Medicare and Medicaid fraud the firm committed.

Attorney General Eric T. Schneiderman and United States Attorney Robert L. Capers announced Wednesday that Zwanger & Pesiri Radiology Group, LLP, Zwanger Radiology P.C. and Dr. Steven Mendelson will pay $8,153,727 in civil damages to resolve allegations that they knowingly submitted false claims to Medicare and Medicaid. It will pay an additional $2.4 million in criminal restitution.

The settlement resolved allegations that from Jan. 1, 2003 through Oct. 26, 2015, Zwanger submitted claims for services provided or supervised by physicians, or at a Zwanger location, that were not enrolled in Medicare and/or Medicaid and therefore ineligible for payment. Zwanger falsely claimed that Mendelson, who was a Medicare and Medicaid enrolled provider, had in fact performed the procedures.

The settlement also resolved allegations that from Jan. 1, 2008 through Feb. 28, 2014, Zwanger submitted false claims to Medicare and Medicaid for certain radiology procedures that were not ordered by a doctor. These procedures included the automatic performance of certain types of x-rays, and the automatic performance of ultrasounds in female patients, even though both procedures were not ordered by a treating physician.

“These defendants knowingly overbilled Medicaid by millions, draining the program of important resources meant to help some of our most vulnerable individuals,” Schneiderman said. “I thank our partners in law enforcement for helping us protect New York taxpayer dollars against fraud and waste. We will continue to vigilantly guard the integrity of Medicaid, and punish those who steal from our state.”

The fraud was uncovered by Linda Gibb and Donna Geraci, who worked for Zwanger-Pesiri. After joining the practice in 2010, Geraci discovered that the company regularly falsified its Medicare and Medicaid claims for service rendered. Senior executives directed her to do whatever was necessary "to get the claims paid." Despite her warnings that this constituted fraud, Zwanger-Pesiri's practices continued.

Gibb complained repeatedly about how the improper practices, such as automatically performing pelvic and transvaginal ultrasounds on female patients despite their doctors only ordering one of the tests.

Zwanger is headquartered in Lindenhurst and has offices in various locations on Long Island. It provides a variety of diagnostic testing, radiology and imaging services to referred patients.

Photo: Alex Costello/Patch