Wednesday, March 7, 2012

Mario Roncal Charged for Allegedly Treating Patients Without a License, Falsifying Billings to Medicare


Source-  http://www.fbi.gov/newark/press-releases/2012/medical-assistant-charged-for-allegedly-treating-patients-without-a-license-falsifying-billings-to-medicare 

NEWARK—A federal grand jury has indicted a medical assistant for a pair of large medical services companies with offices in New Jersey and New York who allegedly posed as a doctor and treated patients without a license, U.S. Attorney Paul J. Fishman announced.

Mario Roncal, 60, of Woodland Park, New Jersey, is charged with one count of conspiracy to commit health care fraud. Roncal surrendered this morning to special agents of the FBI in Newark and is expected to appear before U.S. Magistrate Judge Cathy L. Waldor this afternoon in Newark federal court.

According to the indictment returned on March 2, 2012 and unsealed today:

Roncal has a medical degree from San Juan Bautista School of Medicine in San Juan, Puerto Rico, but is not licensed to practice medicine in New Jersey, New York, or any other state. Roncal is ineligible under New Jersey law to obtain a medical license in New Jersey because San Juan Bautista School of Medicine is not properly accredited and he lacks certain requirements for international medical students.

From approximately 2004 through 2008, Roncal was employed as a medical assistant at a pair of companies owned and run by the same chief executive officer. Cardio-Med Services, LLC (“Cardio-Med”), provided cardiology, internal medicine, and other outpatient medical services to individual patients and had offices in Union City, Paterson, and West New York, New Jersey. Comprehensive Healthcare & Medical Services, LLC (“Comprehensive Healthcare”), provided the same services in New York and Queens, New York.

Roncal conspired to commit health care fraud with the company’s CEO over a four-year period.

When working at Cardio-Med and Comprehensive Healthcare, Roncal held himself out to fellow employees and to patients as “Dr. Roncal.” He examined new patients as well as the CEO’s follow-up patients and ordered diagnostic tests. Roncal also diagnosed patients with medical conditions and diseases and prescribed courses of treatment, including surgery.

Roncal also falsified the accompanying medical records to create the illusion that the medical services were being provided by the companies’ CEO, a licensed physician and board-certified cardiologist. At the direction of the CEO and otherwise, Roncal forged the CEO’s signature on all paperwork associated with his unlawful services, including on prescription pads and patient charts. Roncal and the CEO enriched themselves by submitting the false billing claims to Medicare.

The count with which Roncal is charged carries a maximum potential penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.




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