New York doctor convicted of ordering unneeded heart tests
Insurers warn consumers about protecting themselves against fraud scams
NEW YORK CITY (12/03/2014)(readMedia)-- The criminal conviction of a New York doctor who subjected patients to unnecessary heart tests is a reminder that consumers in the Empire State need to protect themselves from scams and be alert to medical fraud schemes.
The large number of such scams operating in the state also is a reminder that consumers are paying much more than they should for insurance, according to the New York Alliance Against Insurance Fraud (NYAAIF).
Dr. Rohan Wijetilaka, 65, was sentenced to three years in federal prison on Friday after admitting to the unnecessary tests, plus falsely reporting symptoms and illegally distributing tens of thousand of dangerous prescription painkillers.
He defrauded private insurers, Medicare and Medicaid while running a lucrative Manhattan practice. In recent years, he bought a $1.3-million Upper East Side apartment as a second home. As part of this sentence, Wijetilaka also was ordered to pay $1 million in restitution and a $1-million fine.
Dozens of similar insurance frauds have been uncovered in New York in recent years. They are draining insurance money from healthcare systems, causing ever-increasing costs of health insurance and putting innocent patients at risk, according to NYAAIF.
Consumers can protect themselves and help prevent fraud:
• Check the credentials of medical providers with state medical boards. Determine if they have been disciplined for insufficient patient care or fraud.
• Seek a second opinion if diagnosed with serious illness or the provider orders expensive testing you may not need.
• Keep detailed records of treatments you receive. Include dates, locations, who provided the treatments and what services you received. Also record what medicine, supplies or equipment were provided.
• Carefully review the billing and summary statements you receive after treatment. Are the treatment dates, doctor name(s), facility locations and medical services the same as you remember? Know what medical equipment and supplies your provider ordered, as well.
• Never sign blank insurance claim forms.
• Avoid door-to-door or telephone salespeople who offer you free medical services or equipment.
Consumers who suspect medical providers or others of committing insurance fraud can call the New York Frauds Bureau at 888-FRAUD NY or 888-372-8369, or visit the agency online.
NYAAIF is an alliance of more than 100 insurance companies in New York. NYAAIF was created in 1999 to educate consumers about the cost of insurance fraud and help consumers avoid becoming victims. For more information, visit www.fraudny.org.