A man who charged Medicare and Medicaid for X-rays he had not taken of people who had died has been sentenced to 15 years in jail and ordered to pay almost $2 million in restitution.
A US District Court judge in Cleveland sentenced Thomas O’Lear of Lake Township, Ohio, to 10 years more than his lawyers asked for on Friday. In April, a jury convicted O’Lear, the president of a mobile X-ray company that worked with long-term care facilities, of defrauding Medicare and Medicaid and trying to cover up the fraud and related identity theft.
From 2013 through 2017, O’Lear submitted false claims for reimbursement to Medicare, Medicaid and managed care organizations for thousands of X-rays and related services that he and his business – Portable Radiology Services – did not provide. They included approximately 151 X-ray services provided to patients on dates after they had died, according to federal prosecutors.
“Nobody needs X-rays after they’re dead, and the taxpayers shouldn’t have to pay for them,” Ohio Attorney General Dave Yost said in a press release. “This crook made victims of everybody who pays taxes, and he deserves every day of his sentence.”
O’Lear also billed Medicare and Medicaid for providing X-ray-related services to beneficiaries at nursing facilities on dates when the beneficiaries either were hospitalized or not at the facilities. O’Lear also took multiple X-rays that had been performed in one visit and falsely claimed that each one had been done on a different day, a situation that requires reimbursement for transporting the portable X-ray equipment on each date.
O’Lear also falsely billed for taking multiple images or views of patients when only one view had been done, authorities said.
As a result of the scheme, court documents state that O’Lear submitted fraudulent bills to Medicare, Medicaid and Medicaid MCOs for approximately $3.7 million and received approximately $2 million in payments as a result of those bills.
“This defendant wrongfully believed that he could cheat taxpayers by targeting nursing facilities and using the stolen identities of vulnerable or deceased individuals to cover up his tracks,” said First Assistant US Attorney Michelle M. Baeppler.
During a Medicaid MCO audit, O’Lear covered up the scheme and committed aggravated identity theft by creating false medical records, including forms for ordering X-rays and radiology reading reports. He falsified X-ray images, sometimes portraying the same image repeatedly as different images of the same patient, or even as images of different patients.
In creating the falsified order forms, he forged the signatures of his employees and the physician he said had ordered the X-rays.
