New York physician pleads guilty to role in fraud scheme

A New York physician pleaded guilty  to receiving kickbacks in exchange for ordering medically unnecessary brain scans.

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Kenneth Fishberger, MD, 75, of East Setauket, N.Y., pleaded guilty to one count of conspiracy to commit healthcare fraud, according to a Nov. 15 Justice Department news release.

The Justice Department alleged that from June 2013 through December 2019, Dr. Fishberger, an internist, conspired with others to order hundreds of medically unnecessary TCD scans in exchange for kickbacks. His co-conspirators included a principal and a salesperson for a medical diagnostics company. 

The department also alleged that Dr. Fishberger and his co-conspirators used false diagnoses to order the brain scans. A co-conspirator would then submit claims to Medicare and other payers, including private insurers, on behalf of the medical diagnostics company for payment. Dr. Fishberger received kickbacks of approximately $100 per test. Approximately $891,978 in fraudulent claims were submitted to Medicare and private payers.

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