KC Pediatrician Pleads Guilty to $300,000 Medicare Fraud
Fraudulent Claims for More Than 1,000 Patients was Part of Nationwide Scheme
KANSAS CITY, Mo. – A Kansas City-area pediatrician pleaded guilty in federal court today to his role in causing fraudulent Medicare claims to be submitted for more than 1,000 beneficiaries for medications and equipment they didn’t need, which was part of a larger nationwide scheme to defraud Medicare.
“A physician abused his position of trust to cause fraudulent claims to be filed for more than 1,000 Medicare beneficiaries,” said U.S. Attorney Teresa Moore. “This theft of public funds was part of a larger nationwide scheme that includes prosecutions in other districts where additional perpetrators are being held accountable for their criminal actions.”
“To help protect the federal health care system, doctors participating in the Medicare program are obligated to provide medically appropriate services and prescriptions to their patients and bill the program properly,” stated Special Agent in Charge Curt L. Muller with the U.S. Department of Health and Human Services Office of Inspector General. “Our agency and law enforcement partners are dedicated to identifying and pursuing providers who disregard these vital responsibilities in exchange for personal enrichment.”
Frederick Scott Dattel, 57, of Leawood, Kansas, waived his right to a grand jury and pleaded guilty before U.S. District Judge Brian C. Wimes to a federal information that charges him with making a false statement related to a health care matter.
Dattel, a licensed medical doctor with a specialty in pediatrics, owns and operates his own medical practice, Kansas City Pediatrics, L.L.C., in Kansas City, Mo.
Between August 2017 and February 2018, Dattel worked as a physician for RediDoc, L.L.C., a commercial telemedicine company. RediDoc’s owners unlawfully profited by paying kickbacks and bribes to doctors so those doctors would sign high volumes of expensive prescriptions and durable medical equipment orders that were not medically necessary.
National Health Care Fraud Conspiracy
RediDoc owners Stephen Luke and David Laughlin have pleaded guilty in the District of New Jersey to conspiracy to commit health care fraud. In this scheme, marketers identified Medicare beneficiaries to target for expensive medications and durable medical equipment, and persuaded beneficiaries to try the medications and medical equipment – even when the beneficiary’s need for those items was not clear and was not discussed with the beneficiary’s doctor. The marketers then transmitted the beneficiaries’ medical information to RediDoc along with the proposed prescriptions or doctors’ orders for medical equipment that included pre-marked check-off boxes for particular drugs or equipment that would yield large reimbursements.
The marketers paid reimbursement proceeds to RediDoc and its owners. These orders were then filled by providers and pharmacies around the country who received lucrative reimbursements from federal health care benefit programs, including Medicare. In many circumstances, the providers and pharmacies then returned a portion of the health insurance reimbursements as kickbacks to the telemedicine companies, who, in turn, paid the doctors who had prescribed or ordered the unnecessary medical equipment and compounds. RediDoc ensured doctors would sign a high volume of expensive beneficiary prescriptions or medical equipment orders by paying the doctors bribes and kickbacks.
Dattel’s Guilty Plea
By pleading guilty today, Dattel admitted that, while working as a physician for RediDoc, he unlawfully caused false and fraudulent Medicare claims to be submitted for prescriptions for durable medical equipment and compounds without examining or speaking to patients and without any physician-patient relationship.
Between August 2017 and February 2018, while practicing telemedicine for RediDoc, Dattel reviewed 1,077 patient files. He issued orders or prescriptions for 1,075 beneficiaries for durable medical equipment, orthotics, and/or compounds. Dattel issued the orders and prescriptions without seeing, speaking to, or otherwise communicating or examining the beneficiaries, and without regard to whether the beneficiaries actually needed the durable medical equipment and compounds. These orders and prescriptions, as Dattel knew, were used to submit false and fraudulent claims to Medicare.
Almost the entirety of Dattel’s completed, signed prescriptions and orders for durable medical equipment and compounds, as he knew, were not legitimately prescribed, not needed, and not used.
As a result of Dattel’s RediDoc prescriptions and orders, between Aug. 28, 2017, and Feb. 26, 2018, Medicare was billed at least $312,392 for durable medical equipment and compounds, and paid at least $211,542 for these orders. Under the terms of today’s plea agreement, Dattel must pay restitution in the full amount of $211,542.
During the same timeframe, RediDoc deposited a total of $22,270 in 13 payments into Dattel’s bank accounts.
Under federal statutes, Dattel is subject to a sentence of up to five years in federal prison without parole. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.
This case is being prosecuted by Assistant U.S. Attorney Brent Venneman and Nicholas P. Heberle. It was investigated by Health and Human Services, Office of Inspector General, the FBI, and the U.S. Office of Personnel Management, Office of Inspector General.