New Jersey Doctor Pleads Guilty to Dangerous Fraud Schemes

“After years of prominence in his field,” said U.S. Attorney Paul Fishman, “Jose Katz will now be remembered for his record-setting fraud.”

According to federal prosecutors, the 68-year-old cardiologist from Closter, N.J.—with offices in both New York City and New Jersey—committed decades-long fraud.  Authorities called it the single largest health care fraud case ever recorded in these states that was perpetrated by a sole practitioner.  The doctor fraudulently billed Medicare, Medicare, and other private insurance companies out of almost $20 million.

But what makes this case even more egregious is that he had patients undergo thousands of medically unnecessary, and potentially life-threatening treatments.  He would falsely diagnose patients so as to have them qualify for insurance coverage for these treatments, then cash in on the profits while putting his patients in danger.

“Katz was so focused on illegal profits,” Mr. Fishman said, “that he directed unlicensed and unqualified providers to treat his patients, ordered unnecessary tests and cavalierly ordered treatments that could have caused patient harm.  Ripping off the government and insurance companies is bad enough; risking patient health in the bargain is inexcusable.”

On top of these offenses, his wife was kept on his offices’ payroll—while doing ‘little or no work’—just so she would qualify for $250,000 in Social Security.  And he spent millions of dollars advertising his services to a number of communities he perceived as ripe for exploitation.

Last week, Katz pleaded guilty to a number of fraud-related charges, with sentencing set for July.

For more, see http://oig.ssa.gov/audits-and-investigations/investigations/prominent-nynj-cardiologist-admits-participating-19-million.