Law Judge Upholds HHS OIG's Exclusion of Owner of Orlando, Florida, Diagnostic Imaging Services Company
The Office of Inspector General (OIG) of the Department of Health & Human Services (HHS) announced today that Administrative Law Judge (ALJ) Steven T. Kessel upheld OIG's exclusion of Michael D. Dinkel from participation in all Federal health care programs under section 1128(b)(7) of the Social Security Act for a period of 8 years.
"I'm the owner of Drew Medical. The buck stops with me," Dinkel acknowledged in his testimony at the hearing.
ALJ Kessel agreed, holding that Dinkel was personally responsible for ensuring that Drew Medical claimed reimbursement appropriately and that his failure to do so "constituted reckless indifference to the propriety of the claims he caused to be presented." He emphasized that point finding Dinkel had a duty "to understand Medicare and Medicaid billing requirements and to apply them scrupulously to the claims that he caused to be presented."
"The decision reached in this case reinforces OIG's use of its administrative authorities, such as exclusion, to hold accountable individuals who engage in Medicare and Medicaid fraud," said HHS Inspector General Daniel R. Levinson.
The United States Department of Justice previously entered into a civil False Claims Act settlement with Dinkel, Drew Medical, and Central Florida Radiology, Inc., for $1,147,564. Prior to the civil settlement, OIG notified Dinkel that OIG intended to exclude him.
"In cases such as these, payment of civil damages is important but not always sufficient. OIG excluded Mr. Dinkel based on the magnitude of the false claims and our assessment that he is untrustworthy and should not be allowed to participate in Federal health care programs," Inspector General Levinson said.
Dinkel is the owner and President of Drew Medical, Inc., a diagnostic imaging services provider located in Orlando, Florida, which provides outpatient radiology services. Based upon evidence presented at an administrative hearing, ALJ Kessel found that Dinkel and Drew Medical submitted false claims to the Medicare and Medicaid programs for services relating to a radiological procedure known as venography. In fact, Drew Medical had not performed any such services. Specifically, Dinkel and Drew Medical presented claims to Medicare and Medicaid for a procedural code that corresponds to injection for extremity venography, whenever MRI and CT procedures with contrast were performed.
ALJ Kessel found that over a more than 2-year period, Dinkel caused the submission of nearly 9,500 false claims seeking more than $1.6 million in reimbursement.
Under section 1128(b)(7) of the Social Security Act, OIG may exclude individuals and entities from Federal health care programs for presenting or causing to be presented claims for items or services that the individual or entity knows or should know were not provided as claimed, or are otherwise false or fraudulent. OIG's exclusion authority is designed to protect the integrity of the Federal health care programs from individuals or entities who present a risk to those programs.
OIG Assistant Special Agent in Charge Kelly A. McCoy investigated the case. Senior Counsel Christina K. McGarvey, David M. Blank, and Robert M. Penezic and Associate Counsel Lauren E. Marziani represented the Inspector General in the litigation of this matter.