A New York-based director of operations and sales for the Northeast region of a mobile medical diagnostics company pleaded guilty to conspiring to offer and pay kickbacks to doctors in exchange for ordering medically unnecessary brain scans. From approximately March 2015 through approximately September 2020, James Rausch, 57, conspired with others, including two managers for a mobile medical diagnostics company that performed transcranial doppler (TCD) scans, to enter into kickback agreements with various doctors. Rausch and his alleged co-conspirators agreed to offer and pay doctors kickbacks, some in cash and others by check, based on the number of TCD ultrasounds the doctors ordered.
Rausch and his alleged co-conspirators created purported rental and administrative service agreements, which on paper made it appear as if doctors were compensated for the TCD company’s use of space and administrative resources of the ordering doctor’s practice based on fair market value and not based on the volume or value of referrals. These agreements were shams that hid the true nature of the arrangement of paying per test. The scheme as a whole resulted in fraudulent bills of approximately $70.6 million to Medicare. Medicare paid approximately $27.2 million to the TCD company for the fraudulent claims.