Former physicians Eugene DeSimone and Salvatore Conte transformed two radiology labs into COVID-19 testing facilities before upcoding simple tests into high-level consultations and evaluations, according to the lawsuit.
The defendants then allegedly used two new companies to spread around payments, despite the duo’s initial two labs being unlicensed to administer rapid COVID-19 tests.
The lawsuit claims that the defendants owe Aetna $580,000 for damages and attorney fees.
Rochelle Park, N.J.-based Open MRI and Imaging of RP Vestibular Diagnostics, two of the defendants’ companies, previously sued Cigna for denying claims for COVID-19 tests.
Becker’s was unable to reach the defendants for comment at the time of publication.
An Aetna spokesperson said the company does not comment on pending litigation.
This story will be updated as more information becomes available.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
