Department of Justice
U.S. Attorney’s Office
Western District of Michigan
FOR IMMEDIATE RELEASE
Thursday, October 29, 2020
Roger D. Beyer, M.D., Sentenced Today and Agrees to Pay Share of Civil Settlement Totaling $1.26 Million to Resolve False Claims Act Allegations
GRAND RAPIDS, MICHIGAN — U.S. Attorney Andrew B. Birge announced today that U.S. District Judge Janet T. Neff sentenced Roger D. Beyer, M.D., to 57 months of incarceration for his involvement in a conspiracy to commit healthcare fraud and 12 months of incarceration to run concurrently for the adulteration of medical devices. Judge Neff also ordered $5,000 in fines in conjunction with the charges as well as three years of supervised release to follow imprisonment for the health care fraud conspiracy charge and one year of supervised release for the adulteration charge. Dr. Beyer owned and operated the now-shuttered Urological Solutions of Michigan (“USM”), a mobile medical practice providing urological services to patients in their homes and assisted living facilities in the greater Traverse City, Grand Rapids, and Kalamazoo areas, and Women’s Health Care Specialists (WHCS), a gynecology practice located in Kalamazoo.
Judge Neff found that Dr. Beyer engaged in several fraud schemes committed by USM and WHCS, resulting in approximately $883,000 in false claims submitted by the practices and paid by Medicare. These schemes included billing pelvic muscle rehabilitation (“PMR) therapy using improper—and more lucrative—diagnostic codes, billing for evaluation and management (“E&M”) services that did not occur, and billing for the services of an unlicensed nurse assistant.
Dr. Beyer was also sentenced for the adulteration of medical devices at USM and WHCS. During the fraud investigation, investigators discovered that USM and WHCS reused a single-user rectal pressure sensor on multiple patients as part of the PMR therapy, covering the device with the finger of a surgical glove. WHCS staff also reused a single-use anorectal manometry catheter on multiple patients as part of an initial diagnostic study with patients with potential fecal incontinence, covering the device with a condom. The reuse of these medical devices was in contravention with the devices’ instructions for use and inconsistent with the device clearances by the Food & Drug Administration (“FDA”). The Federal Food, Drug & Cosmetic Act prohibits the adulteration of medical devices, which includes holding devices under “insanitary conditions” whereby they may have been contaminated with filth or rendered injurious to health.
Judge Neff enhanced Dr. Beyer’s sentencing guidelines based on the fact that an administrative law judge in 2011 ruled that USM should not bill Medicare for the PMR therapy using the diagnostic codes. Despite this explicit judicial order, Dr. Beyer and his practices continued to bill for the PMR therapy using the diagnostic codes, but submitting the billing under USM’s nurse practitioners to “fly under the radar.” Judge Neff also applied an enhancement for the reckless risk of bodily injury to patients related to the reuse of medical devices.
In issuing Dr. Beyer’s sentence, Judge Neff found that Dr. Beyer’s offense was a “significant fraud on a very valuable federal program.” Judge Neff observed that the size of the Medicare program “make it a great target for fraud . . . [but] cheating the government is really cheating all of us and particularly those who need the assistance of the arm of government.” Judge Neff pointed out that while Dr. Beyer pleaded guilty “there was a gross minimization of culpability.” Judge Neff concluded that a significant term of imprisonment was necessary to promote “punishment and respect for the law” and that a sentence of less than incarceration would not sufficiently deter others from similar conduct.
Dr. Beyer’s sentence follows the June 2020 sentencing of Mark Sabor, USM’s practice manager who pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to two years in prison. The investigation also resulted in the conviction of Dr. Beyer’s wife, Susan Wright, a nurse practitioner and attorney, who pleaded guilty to failing to report ongoing fraud at Dr. Beyer’s practice to law enforcement and also the adulteration of medical devices. In September, Judge Neff sentenced Ms. Wright to three years of probation and over 3,000 hours of community service.
As part of a parallel investigation, each defendant also agreed to pay a civil settlement under the False Claims Act to resolve allegations of the submission of false claims for reimbursement to Medicare as part of the numerous alleged healthcare fraud schemes at Dr. Beyer’s practices. Ms. Wright paid $500,000; Mr. Sabor paid $150,000; and Dr. Beyer and his practices agreed to pay $610,000 within five days of sentencing.
“Dr. Beyer and the other defendants engaged in a course of fraudulent conduct for many years, despite multiple warnings—including a decision by an administrative law judge—to do things the right way,” stated U.S. Attorney Birge. “But their greed-fueled misconduct didn’t just hurt the Medicare program. Instead, by reusing single-use and single-user medical equipment in these procedures on multiple patients, they recklessly risked the lives and health of their patients. The outcome of this case demonstrates that medical professionals in our district cannot flaunt Medicare billing rules or adulterate medical devices without consequence.”
“U.S. consumers rely on FDA oversight to ensure that medical devices are safe and effective,” said Lynda M. Burdelik, Special Agent in Charge of FDA’s Office of Criminal Investigations, Chicago Field Office. “When healthcare providers disregard safety information, including single-use and single-user designations, they put patients’ health at risk. We will continue to investigate and bring to justice providers that jeopardize the public health.”
“The defendants’ involvement in healthcare fraud schemes for medical services not rendered and upcoding services provided was motivated by greed,” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General – Chicago Region (“HHS-OIG”). “Their conduct demonstrates an aggravated indifference for the law and a disregard for the safety and well-being of vulnerable citizens given that the defendants carried on these schemes after being corrected by Medicare’s contractor and an administrative law judge and given the reuse of adulterated medical equipment on Medicare patients. HHS-OIG will continue to work with our prosecutorial and law enforcement partners to ensure that those who commit these criminal acts are held accountable.”
Dr. Beyer and Susan Wright broke laws designed to protect Medicare and regulations designed to protect patient safety. Their behavior was in direct conflict with the oath they took to ‘do no harm,’” said Federal Bureau of Investigation (“FBI”) Acting Special Agent in Charge David G. Nanz. “The FBI in Michigan will continue to investigate the type of cases in which medical professionals put profits over patient safety and waste taxpayer dollars by defrauding publicly-funded medical care.”
This case was the result of a joint investigation by HHS-OIG, FDA’s Office of Criminal Investigations, and the FBI, in coordination with the U.S. Attorney’s Office for the Western District of Michigan. Assistant U.S. Attorney Raymond E. Beckering III prosecuted the criminal case, and Assistant U.S. Attorney Andrew J. Hull represented the United States in the civil case.
Health Care Fraud
USAO – Michigan, Western
Article source: http://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/west-michigan-urogynecologist-sentenced-prison-healthcare-fraud-and-adulteration-medical-devices