Endoscopy Center CEO Sentenced in Billing Fraud Scheme
LAS VEGAS, NV—Tonya Rushing, former CEO of the now-defunct Endoscopy Center of Southern Nevada, was sentenced today by Senior U.S. District Judge Larry R. Hicks to one year and one day in prison for conspiring with Dipak Desai, the former owner of the center, to commit health care fraud, announced U.S. Attorney Daniel G. Bogden for the District of Nevada.
Rushing, 47, who pleaded guilty last July to conspiracy to commit health care fraud, must also serve two years of supervised release, perform 150 hours of community service, and pay a $10,000 fine and $50,000 in restitution. An order of forfeiture was also ordered for $8.1 million.
“Those perpetrating Medicare and Medicaid fraud cheat both taxpayers and vulnerable patients,” said U.S. Attorney Bogden. “We will hold criminals accountable and will seek to recover stolen dollars in each case of healthcare fraud we prosecute.”
Between about January 2005 and February 2008, Desai and Rushing conspired to overcharge Medicare, Medicaid, and other private health insurance companies at the Endoscopy Center of Southern Nevada by significantly overstating the amount of time the certified registered nurse anesthetists spent with patients on a given procedure. Desai and Rushing created a separate company, Healthcare Business Solutions, owned by Rushing, to handle the billing for the anesthesia services. This company received approximately nine percent of all money collected for anesthesia services rendered at the endoscopy center. Desai and Rushing imposed intense pressure on the endoscopy center employees to schedule and treat as many patients as possible in a day, and instructed the nurse anesthetists to overstate in their records the amount of time they spent on the anesthesia procedures. Desai and Rushing also instructed the office staff to rely on the false anesthesia records when preparing the claims for reimbursement which were sent to Medicare, Medicaid and the insurance companies. The plea agreement states that Rushing received approximately $1.3 million as her share of the inflated anesthesia billing scheme.
Desai pleaded guilty on April 2, 2015, to one count of conspiracy to commit health care fraud, one count of health care fraud, and is scheduled to be sentenced on July 9.
This case was investigated by the FBI, Office of the Nevada Attorney General, Health and Human Services Office of Inspector General, Department of Labor Office of Inspector General, Food and Drug Administration Office of Criminal Investigations, and the United States Postal Inspection Service, and prosecuted by Assistant U.S. Attorney Crane M. Pomerantz and Mark N. Kemberling, who was designated as a Special Assistant U.S. Attorney on this case and is Chief Deputy Nevada Attorney General.
According to a recent report by the Inspector General for the U.S. Department of Health and Human Services, for every dollar the Departments of Justice and Health and Human Services have spent fighting health care fraud, they have returned an average of nearly eight dollars to the U.S. Treasury, the Medicare Trust Fund and others. To learn more or to report Medicare fraud, go to http://www.stopmedicarefraud.gov/.