Cardinal Respiratory Ordered to Pay $2.5 Million in Restitution and Fines for Health Care Fraud
Springfield, Ill – U.S. District Judge Jeanne E. Scott today ordered Cardinal Respiratory P.C., a Springfield medical practice that specializes in allergies and immunology, to pay $2.5 million in restitution and fines, including refunding $245,655 to patients, for engaging in fraudulent and abusive billing practices for nearly a decade. Judge Scott further sentenced the corporation to a five-year term of probation and ordered the corporation to pay a criminal fine of $1.5 million.
Cardinal Respiratory pled guilty in October 2007 to one count of felony health care fraud. At that time, the corporation agreed to deposit $2,549,986 with the Clerk of the Court for the Central District of Illinois to be used toward whatever restitution and fine were ordered at sentencing. The Clerk of the Court will be responsible for disbursement of restitution payments of $245,655 to approximately 288 patients whose claims were analyzed and approved by a court-appointed receiver; $528,016 to Blue Cross and Blue Shield of Illinois; $92,754 to Healthlink; and $67,643 to Medicare. Fees to the court-appointed receiver, $52,626, will also be paid from the set-aside funds.
The U.S. Attorney for the Central District of Illinois, Rodger A. Heaton, stated, “This outcome is particularly gratifying because we were able to assist 288 patient victims in recovering money paid to their physician as a result of fraudulent and abusive billing practices.”
According to court documents and as admitted by the corporation during court hearings, Cardinal Respiratory, of 1200 Centre West Drive, engaged in a pattern of fraudulent and abusive billing and collections from about 1997 through at least October 2006. Cardinal submitted various fraudulent claims for payment, including the following:
- billing for basic office medical supplies, such as syringes, alcohol wipes, mouthpieces and filters;
- billing for dozens or hundreds of doses of allergen preparations when far fewer doses were actually prepared;
- double billing for allergen immunotherapy injections; and,
- balance billing of charges rejected by Medicare or insurance companies directly to patients to which finance charges, interest and late payment fees were added.
In a related case, Dr. Janet Despot, who owns and practices medicine at Cardinal Respiratory, was fined $10,000 on February 4, 2008, after pleading guilty to illegal balance billing in violation of her agreement with Medicare, a misdemeanor offense.
Under terms of her plea, Despot agreed to facilitate the corporation’s guilty plea and to fulfill the corporation’s obligations under that agreement. Despot also agreed to a permanent injunction on her behalf and on behalf of Cardinal Respiratory which, among other things, permanently bars her husband, Rickey Weir, previously employed by Despot as business manager for Cardinal Respiratory, from performing any function in any way related to her medical practice, current and future.
Weir, 61, remains charged by indictment with 15 counts of mail fraud and one count of health care fraud. Trial for Weir is scheduled to begin on February 3, 2009. Weir remains detained in federal law enforcement custody pending trial after his release was revoked in November.
Members of the public are reminded that an indictment is merely an accusation; the defendant is presumed innocent unless proven guilty.
If convicted, each count of mail fraud carries a maximum statutory penalty of 30 years imprisonment and a $250,000 fine; the penalty for health care fraud is up to five years imprisonment and a $250,000 fine.
The investigation was conducted by the Central Illinois Health Care Fraud Task Force which includes agents of the U.S. Health and Human Services Office of Inspector General, Federal Bureau of Investigation, the Illinois State Police’s Medicaid Fraud Control Unit, U.S. Postal Inspection Service, Illinois Attorney General’s Office and the Illinois Department of Public Aid. Assistant U.S. Attorneys Patrick D. Hansen and Eric Long are prosecuting the case.
James A. Lewis
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