On July 21, 2011, the Office of Inspector General (OIG) of the Department of Health & Human Services (HHS) announced 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.
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.
ALJ Kessel held Dinkel 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.” ALJ Kessel 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.”
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.
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 under section 1128(b)(7) of the Social Security Act, which provides OIG the power to 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.
For professional assistance navigating the ever-evolving healthcare landscape or for more information regarding government investigations, please contact Adrienne Dresevic, Esq., Alan G. Gilchrist, Esq. or Carey F. Kalmowitz, Esq. at (248) 996-8510 or (212) 734-0128, or visit the HLP website.