New Jersey Cardiologist Ordered To Pay $19 Million And Serve More Than 6 Years In Prison In Connection With Massive Health Care Fraud Scheme

Earlier this year, a New Jersey cardiologist, Jose Katz, pled guilty to conspiracy to commit health care fraud and social security fraud.  He has now been sentenced to serve 78 months in prison and to pay $19 million in restitution.

The health care fraud charges arose out of a scheme under which Katz had his cardiology and internal medicine patients undergo tests at his diagnostic testing companies – Cardio-Med Services, LLC and Comprehensive Healthcare & Medical Services, LLC.  Prosecutors claimed that the same procedures were ordered regardless of the symptoms each individual was actually experiencing.  Katz admitted that he directed his employees to order tests for patients who were being treated by other doctors who worked in his office and for whom Katz, himself, provided no treatment.  Insurers were then billed for the unnecessary services. 

Katz was also accused of falsifying charts to document symptoms the patient wasn’t experiencing and then diagnosing the individual with angina.  This diagnosis allowed Katz to prescribe and administer a treatment called enhanced external counter pulsation.  This procedure was given to some people who could have suffered serious injury or death as a result.  These treatments supposedly accounted for $15.6 million of the $19 million in fraudulent billing.  According to the U.S. Attorney’s Office, this is the largest health care fraud amount for New Jersey, New York and Connecticut. 

In connection with his guilty plea to social security fraud, Katz admitted that he gave his wife a “no-show” job at Cardio-Med Services to allow her to earn Social Security benefits.  Katz’s wife apparently earned approximately $263,000 in Social Security benefits to which she was not entitled. 

Katz also represented that another person, Mario Roncal, was a doctor even though Roncal wasn’t actually licensed.  Katz then permitted Roncal to examine patients and order tests as Katz had done.  Roncal has pled guilty to conspiracy to commit health care fraud and is waiting to learn what his sentence will be.