Fishy Business and Fraudulent Bills: New York Internist Pleads Guilty to $891K Healthcare Fraud Scheme
The Hippocratic Oath was apparently not an ethical pledge Dr. Kenneth Fishberger took to heart.
On Thursday, November 14, 2024, New York internist Dr. Fishberger, 75, pleaded guilty in Boston federal court to one count of conspiracy to commit healthcare fraud. Fishberger, an internist from East Setauket, N.Y., received kickbacks for ordering medically unnecessary transcranial doppler (TCD) brain scans, tests used to measure blood flow in parts of the brain.
Fishberger was a licensed medical doctor in the State of New York for approximately 47 years. From June 2013 through December 2019, Fishberger and his co-conspirators, an executive for a mobile medical diagnostics company that performed TCD scans and a salesperson for the company, conspired to order hundreds of medically unnecessary TCD scans, in exchange for kickback payments.
How did Fishberger orchestrate the fraud? He and his co-conspirators issued false diagnoses to patients to order unnecessary brain scans. A co-conspirator would then submit false claims to Medicare, other insurance companies, and private insurance companies for payment. Fishberger received cash kickbacks totaling approximately $100 per test, according to prosecutors. Charging documents indicate that the scheme’s fraudulent bills totaled approximately $891,978 to Medicare and insurance companies.
Sentencing is scheduled for February 25, 2025, by Judge Nathaniel M. Gorton. The charge of conspiracy to commit healthcare fraud can result in a sentence of up to 10 years in prison, three years of supervised release, and a fine of up to $250,000.
U.S. Attorneys Howard Locker and Mackenzie Queenin of the Health Care Fraud Unit are prosecuting the case under Acting United States Attorney Joshua S. Levy. The case also involved the collaboration of many agencies, including the U.S. Department of Health and Human Services, the Office of the Inspector General, and the Boston divisions of the Federal Bureau of Investigation, the Internal Revenue Service, the Department of Labor, and the U.S. Postal Inspection Services.
Healthcare fraud is wasteful and has serious consequences. Fishberger’s case underscores ongoing issues with healthcare billing fraud and the continuing need to uncover schemes by professionals and institutions that betray the public trust.
Such schemes should be reported, and we count on the public to speak up when fraud is identified. If you have any information about potential healthcare or pharmaceutical fraud, violations of the Anti-Kickback Statute and Stark Law, ordering medically unnecessary services, or would like to learn more about whistleblower protection laws, you can speak to an experienced Constantine Cannon whistleblower lawyer team member. Please don’t hesitate to contact us for a free and confidential consultation.
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