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Owners, worker at clinics indicted

Clinics
Jun. 27, 2013 @ 11:47 PM

COAL GROVE, Ohio — A federal grand jury has charged four people with health care fraud in connection with procedures performed at two Coal Grove clinics, according to a news release.

Peter Tsai, 44, owner of Advanced Family Medical Center, his father and mother, Tahsiung Tsai, 72, and Ruey Tsai, 66, who owned Watkins-Tsai Imaging and Peter Tsai's cousin, Wei Lih "Wendy" Sheih, 41, who worked at both clinics, are charged with conspiring to defraud health care benefit programs including Medicaid and Medicare.

They are accused of improperly charging government insurance programs for medically unnecessary procedures in connection with two medical clinics they owned and operated in Coal Grove. The indictment was unsealed Thursday, and Peter Tsai and his parents were arrested Thursday morning, according to the release.

All three were transported to federal court in Cincinnati for an initial appearance before U.S. Magistrate Judge Karen Litkovitz. They were released on recognizance bond after they surrendered their passports, according to the release. Sheih also was released on recognizance bond.

"The grand jury has charged them with performing diagnostic CT scans that were medically unnecessary, including multiple scans of the same body part for the same patient weeks apart," Carter M. Stewart, U.S. Attorney for the Southern District of Ohio, said in a prepared release.

They are also charged with performing and billing for CT scans for medically unnecessary injection of Synvisc, an osteoarthritis product, in knees, including injections into young adults without any proper diagnosis of osteoarthritis, and for other unneeded procedures, Carter said.

The defendants also ignored and/or stopped documenting statements and complaints from patients that some injections were not working or not wanted. They also are charged with illegally importing adulterated Synvisc from other countries, including Canada and Turkey, and billing government insurance programs for the injections and transferring money into an account in a Canadian financial institution.

"We take allegations of health care fraud very seriously," Ohio Attorney General Mike DeWine said in a prepared release. "We will not tolerate those who seek to overbill and perform unnecessary tests on patients."

All four defendants are charged with conspiracy, a charge that carries a maximum 10-year prison sentence. Peter Tsai and his parents were charged with health care fraud, punishable upon conviction of up to 10 years in prison. Peter Tsai is charged with smuggling, a charge that carries a maximum 30-year prison sentence, and money laundering, which carries a maximum 20-year prison sentence.

The indictment also seeks forfeiture of all proceeds received as a result of the alleged conspiracy.

(An indictment is a formal charge made against a person by a grand jury. It does not establish guilt or innocence.)

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