The U.S. Attorney’s Office for the Western District of Michigan announced separate charges against a Kalamazoo urogynecologist and a nurse practitioner accused of committing health care fraud and reusing single-use medical equipment.
Roger Beyer, M.D., was charged with conspiracy to commit health care fraud. His wife, Susan Wright, N.P., was charged with misprision of health care fraud and the adulteration of a medical device. It is unclear if they have acquired legal representation.
According to the indictment, the doctor of Kalamazoo was the owner of two medical practices: Women’s Health Care Specialists (WHCS) and Urological Solutions of Michigan (USM). He is accused of conspiring to fraudulently bill Medicare for therapy services provided by USM, such as pelvic muscle rehabilitation (PMR) therapy, using inappropriate diagnostic codes. In health care, diagnostic codes refers to the coded written descriptions that are used to group and classify illnesses, diseases, and injuries; medical coding fraud occurs when a health care provider knowingly submits claims to insurers with incorrect diagnostic codes.
The doctor allegedly provided PMR therapy to mostly elderly women with fecal or urinary incontinence. He purportedly directed his staff to reuse rectal pressure sensors meant to be used once on multiple patients as part of the therapy. His staff also allegedly reused single-use anorectal manometry catheters on multiple patients as part of an initial diagnostic study with patients who had potential fecal incontinence.
Both instances of reuse went against the device manufacturers’ instructions for use, as well as guidelines set by the Food & Drug Administration (FDA) to prevent the adulteration and possible contamination of these devices.
The wife was allegedly aware that her husband fraudulently billed Medicare for evaluation and management services to patients who received PMR therapy, but she never alerted authorities. She additionally faces charges of adulteration of a medical device for reusing rectal pressure sensors on behalf of her husband. It is not clear whether any other medical staff at the practices has been accused of wrongdoing.
Adulterated medical devices pose a serious risk of infection disease transmission. The patients of USM and WHCS who received PMR therapy or diagnostic anorectal manometry are encouraged to contact their physicians and undergo testing.
Patients who were Medicare beneficiaries may have been charged copays for the billing of their PMR therapy using more lucrative diagnostic codes. They may also have been improperly billed for evaluation and management services alongside their PMR therapy. Potential victims of Beyer’s alleged fraudulent billing or device adulteration are asked to contact the U.S. Attorney’s Office for the Western District of Michigan to obtain information about their rights.
Sources indicate that the doctor and his wife have signed plea deals in their respective cases, and plea hearings are scheduled in May 2020. The U.S. Attorney’s Office noted that charges are not evidence of guilt, and defendants are presumed innocent unless the government proves they are guilty beyond a reasonable doubt.
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