Wednesday, April 10, 2013

Corruption: Clinical laboratory, exec charged in multi-million-dollar kickback scheme.

U.S. Attorney’s Office 
District of New Jersey

NEWARK, NJ—Federal agents arrested the president and part-owner of Parsippany, New Jersey-based Biodiagnostic Laboratory Services LLC (BLS), a New Jersey physician, and two other BLS employees this morning on charges they participated in a long-running scheme to bribe doctors to refer patient blood samples to BLS and to order unnecessary tests, resulting in tens of millions of dollars in profit for the company. The charges were announced today by New Jersey U.S. Attorney Paul J. Fishman.

BLS president David Nicoll, 39, of Mountain Lakes, New Jersey; Scott Nicoll, 32, of Wayne, New Jersey, a senior BLS employee and David Nicoll’s brother; and Craig Nordman, 34, of Whippany, New Jersey, a BLS employee and the CEO of Advantech Sales LLC—an entity used by BLS to make illegal payments—are charged in a federal complaint with conspiring to bribe physicians over a period of several years. BLS is also charged with the conspiracy.

Frank Santangelo, 43, of Boonton, New Jersey, a New Jersey physician with offices in Montville and Wayne, is charged in the complaint for allegedly accepting bribes to refer patients to BLS and violating his duty of fidelity to his patients. Santangelo allegedly received more than $700,000 in bribe payments from BLS and sent the company more than $4.2 million in blood referrals.

The defendants are scheduled to appear this afternoon before U.S. Magistrate Judge Madeline Cox Arleo in Newark federal court.

“People depend on their doctors to make medical decisions about care based solely on medical need,” said U.S. Attorney Fishman. “When doctors order extra tests or choose particular labs in exchange for cash, they abandon their obligation to their patients and to all of us who support our nation’s health care system. No patients should have to worry that their doctors’ loyalty and judgment have been bought by a salesman trying to make a buck.”

“The FBI views health care fraud as a severe crime problem that affects every American,” said FBI Special Agent in Charge Aaron T. Ford. “Fraud and abuse take critical resources out of our health care system and contribute to the rising cost of health care for everyone. Today’s arrests are the result of a long term, multi-agency investigation into a complex health care fraud scheme, requiring substantial investigative resources. The FBI, with its law enforcement partners, will continue to provide a significant amount of expert resources to investigate these crimes.”

“Kickbacks have no place in the healthcare industry. Financial inducements only cloud medical judgment. This elaborate kickback scheme had one goal, and that is greed,” said Tom O’Donnell, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Federal and state taxpayers, and vulnerable patients, deserve better.”

According to the complaint unsealed today:

Between 2006 and 2013, BLS and entities it funded paid millions of dollars to physicians to induce them to refer patient blood samples to BLS. From these referrals, BLS received at least tens of millions of dollars from private health insurance companies and Medicare.

Numerous physicians were bribed under the guise of lease, service, and/or consulting agreements. Under the lease and service agreements, between 2006 and 2009, physicians were frequently paid thousands of dollars a month by BLS for space in medical offices that BLS did not need or actually use and to perform routine blood drawing services that had little real dollar value.

In a text message referenced in the complaint, David Nicoll wrote to Santangelo about the status of their referral agreement, stating that BLS “really can’t afford the 40-50,000 [dollars] a month if the girls aren’t going to be drawing any blood,” to which Santangelo responded by stating, “U no u can count on me” and “I never let u down.”

When the state of New Jersey sought to address the problem of laboratories using lease agreements to bribe physicians for referrals—effectively prohibiting all leases between blood laboratories and physicians in 2010—BLS, David Nicoll, Scott Nicoll, and Nordman funded and used at least half a dozen entities to disguise bribe payments to physicians.

In one example from the complaint, a physician was paid $1,500 per month by Nordman—who identified himself as both a BLS employee and the CEO of Advantech—for spending less than two minutes each month filling out a one-page questionnaire asking how often sales representatives visited the physician’s office, which insurance companies were in-network for the physician and which out-of-network insurance companies did the physician bill. In reality, the payments were to refer patients’ blood samples to BLS.

Various recorded conversations are also detailed in the complaint, including one in which Nordman urges another physician to order “more tests,” stating, “That’s where it really is. I mean, if we get 10 bloods for $1,000 as opposed to 10 bloods for $4,000 or five bloods for $4,000, obviously there’s more. We get paid a percentage, obviously.” In a second conversation, Scott Nicoll tells this same physician, “I would like to be able to get you, you know, around 1,500 [dollars] a month if I can, but I need—we would either need more tests or more patients or something along those lines...you’re doing about a $1,000 a bag per patient...if we could, we could somehow get that up in the two’s then I’m looking at making 4,000, and I have no problem paying you know 1,500 [dollars] for it.”

Over the course of the charged conspiracy, BLS has made more than $200 million from the testing of blood specimens and related services. David Nicoll received more than $33 million in distributions from BLS during that same time period, during which he also spent millions on personal items: more than $5 million on high-end and collectible automobiles, including approximately $580,000 for a Yenko Nova and approximately $365,000 for a Yenko Chevelle, approximately $300,000 for a Ferrari, and approximately $291,000 for a Corvette; more than $700,000 to purchase a Manhattan apartment for a female companion; $600,000 on private jet charters; $392,000 on tickets to sporting events; $216,000 at electronics stores; and $154,000 at a gentleman’s club and restaurant.

“It is alleged in today’s complaint that the president and other employees of BLS bribed physicians to refer patients to their lab and order unnecessary lab tests, reaping millions of dollars, all in the name of greed,” stated Shantelle P. Kitchen, Acting Special Agent in Charge, IRS-Criminal Investigation, Newark Field Office. “Medical tests should only be run when medically necessary, not so someone can buy exotic cars and charter private jets. This type of health care fraud will not be tolerated and IRS-Criminal Investigation, along with our law enforcement partners, will vigorously investigate these crimes to bring the perpetrators to justice.”

“Postal Inspectors, along with other law enforcement agents, unraveled a sophisticated false billing scheme that resulted in millions of dollars in losses,” said Acting Inspector in Charge Maria Kelokates, Newark Division of the U.S. Postal Inspection Service. “Postal Inspectors will continue to aggressively pursue investigations in which the U.S. mail is used to facilitate a crime.”

David Nicoll, Scott Nicoll, and Nordman are charged with one count of conspiring to violate the Anti-Kickback Statute and the Federal Travel Act. Santangelo is charged in two counts—with substantive violations of the Anti-Kickback Statute and the Federal Travel Act, for allegedly using the interstate mails in aid of commercial bribery. If convicted, the defendants face a maximum potential penalty of five years in prison on each of the counts with which they are charged. Each count also carries a maximum $250,000 fine, or twice the gross gain or loss from the offense. BLS is also charged with the conspiracy, and faces a maximum potential penalty of five years of probation and a $500,000 fine, or twice the gross gain or loss.

U.S. Attorney Fishman praised special agents of the FBI, under the direction of Special Agent in Charge Ford; U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge O’Donnell; IRS–Criminal Investigation, under the direction of Acting Special Agent in Charge Kitchen, and the U.S. Postal Inspection Service, under the direction of Acting Inspector in Charge Kelokates.

The government is represented by Senior Litigation Counsel Andrew Leven, Assistant U.S. Attorney Melissa Jampol and Deputy Chief Jacob T. Elberg of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark, as well as Assistant U.S. Attorney Barbara Ward of the office’s Asset Forfeiture and Money Laundering Unit.

The charges and allegations contained in the complaint are merely accusations, and the defendants are presumed innocent unless and until proven guilty.