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Civil action seeks $1.1 million from radiologist accused of fraud

Federal officials want to claw back $1.1 million from a former Rochester-area radiologist who last year was accused of defrauding Medicare, Excellus BlueCross BlueShield and MVP Health Care.

A civil forfeiture suit filed by the U.S. attorney in U.S. District Court in Rochester seeks to claim assets held by Thomas Stephenson M.D. The action comes some 10 months after federal prosecutors charged Stephenson criminally for allegedly submitting fraudulent X-ray and bone-density test billings.

Stephenson, 71, double-billed Medicare and private insurance companies for studies done over a three-year span beginning in 2007 and ending in April 2010, Assistant U.S. Attorney John Field claimed in a Sept. 22, 2014, information.

As the Rochester Business Journal reported last year, Stephenson waived indictment. He has yet to enter a plea to the criminal health care fraud charges alleged in the information. 

From 2007 to 2010, Stephenson practiced in two radiology groups that no longer are active. He first was partner in Monroe Radiological Associates P.C. and later in Westside Imaging P.C. His fraud consisted of submitting claims for two imaging studies when he had only conducted one, Field alleges in the information.

The 2014 information details allegedly fraudulent billings by Stephenson totaling $189,000.

The forfeiture action significantly ups the ante, describing the radiologist’s improper claims as totaling more than $800,000. The additional alleged frauds were uncovered in a more detailed financial analysis conducted after the initial charges were filed, the forfeiture complaint states.

Neither the 2014 filing nor the more recent civil forfeiture action detail how Stephenson’s allegedly fraudulent claims were parceled out among Medicare, Excellus and MVP.

Citing the ongoing nature of forfeiture litigation and the still-unresolved criminal charges against Stephenson, James Redmond, Excellus vice president of communications, declined to comment.

MVP spokeswoman Jacqueline Marciniak also declined to comment, citing similar concerns.

The forfeiture action traces a series of fund transfers among bank accounts held by Stephenson as part of what the court filing claims was a money-laundering scheme.

“A detailed analysis of the bank records shows that Dr. Stephenson purchased seven separate assets with each purchase being funded with more than $10,000 in specified unlawful activities proceeds … collectively valued at $1,094,000.00,” the filing states.

Discussions between Stephenson’s attorneys and federal officials over a global agreement to settle criminal and civil charges against the radiologist have been ongoing since last September, Stephenson’s criminal docket shows.

Court records show that Stephenson’s lawyers, citing additional material introduced by government prosecutors, in January asked for Stephenson’s court proceedings to be postponed.

Citing still-unresolved issues in a global plea deal, they again asked for postponements in March, April and May.

A hearing had been scheduled for June 17, a day after the civil forfeiture’s filing. That hearing also was postponed so Stephenson’s lawyers and federal prosecutors could continue to hammer out a plea agreement, court records state. A court date is currently scheduled for June 30.

Lawyers representing Stephenson in the criminal and civil cases—criminal defense attorney John Speranza, and Mary Jo Korona of Leclair Korona Giordano Cole LLP—did not respond to requests for comment.

6/26/15 (c) 2015 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email [email protected]

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