Tammy Dickinson, United States Attorney for the Western District of Missouri, announced today that a Jefferson City, Mo., physician has pleaded guilty in federal court to making false statements in order to receive payments on health care claims.
Randall E. Meyer, 60, of Jefferson City, waived his right to a grand jury and pleaded guilty before U.S. Chief District Judge Greg Kays on Friday, May 13, 2016, to a federal information that charges him with making false statements related to health care matters.
Meyer, a physician and surgeon, is a partner at Central Missouri Cardiology, P.C., a cardiology practice group in Jefferson City. Under the terms of his plea agreement, Meyer must surrender his medical license two weeks prior to his sentencing hearing, which has not yet been scheduled.
This case involves Meyerâ€™s treatment of 14 patients from Jan. 1 through Dec. 31, 2010. Meyer admitted that he claimed the percentage of the patientsâ€™ lesions and stenosis in their arteries was 70 percent or greater when, in fact, it was substantially less. Meyer used his misstatement of the significance of the lesions and stenosis to ensure the claims would be paid. He then submitted (or caused to be submitted) claims for payment for treatments or services to health care benefit programs.
The health care benefit programs would not have allowed, reimbursed, or paid those claims if the programs had known Meyer was inflating the percentage of patient lesion and stenosis.
The estimated loss amount for purposes of sentencing is more than $95,000 but less than $150,000. Under the terms of his plea agreement, Meyer must pay $76,369 in restitution, based on the estimated loss to the private insurers who reimbursed the claims. However, the government has not waived its right to pursue civil or administrative remedies with respect to the claims Meyer submitted (or caused to be submitted) to federal payors through the False Claims Act.
Explanation of Medical Terms
Stenosis is an abnormal narrowing in a blood vessel. A stent is a tube or other device placed in the body to create a passage between two hollow spaces and/or widen a narrow blood vessel. Coronary stents are placed during percutaneous coronary intervention (PCI), also known as an angioplasty. The most common use for coronary stents is in the coronary arteries, into which a bare-metal stent or drug-eluting stent is inserted. When a patient is determined to have stenosis to a degree that justifies intervention, and is undergoing a PCI, a physician must accurately document and maintain in the medical record his or her findings for the need to treat the patient, and any intervention and subsequent treatment.
This case is being prosecuted by Senior Litigation Consultant Gregg R. Coonrod and Assistant U.S. Attorney Cindi Woolery. It was investigated by Health and Human Services â€“ Office of the Inspector General, the FBI, the U.S. Department of Labor â€“ Employee Benefits Security Administration and the Missouri Attorney Generalâ€™s Medicaid Fraud Control Unit.