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Two East Islip doctors agree to pay $1.1M in false Medicare claims case, prosecutors say

Two doctors who were affiliated with an East Islip general practitioner's office have agreed to pay more than $1.1 million to resolve charges that they submitted claims to Medicare for procedures that were not medically necessary, federal prosecutors said Wednesday.

Dr. Vikas Desai, the principal of East Islip Family Care, and Dr. Robert Maccone, a physician who was previously affiliated with the practice, entered into separate civil agreements to pay the United States a total of $1,120,299, according to the office of acting U.S. attorney for the Eastern District of New York Kelly T. Currie.

Prosecutors said Desai, Maccone and the late Dr. Edmond Ross, all of whom who were affiliated with East Islip Family Care at one time, ordered and performed nerve conduction studies on patients who didn't medically need them. The procedure involves the electrical stimulation of a patient's nerves and muscles to measure the conduction speed of electric impulses and nerve and muscle function, Currie's office said.

Prosecutors said the tests involve administering low levels of electric shocks to patients and can be uncomfortable and even painful.

The government alleged that Desai, Ross, and Maccone ordered the studies despite the lack of apparent need for them, and that when nerve studies were needed, they weren't performed correctly. For example, a patient with arm complaints was given leg nerve studies, the government said. The defendants were charged with falsely submitting thousands of claims for those studies to Medicare.

Desai has agreed to settle the allegations of medically unnecessary billings made by him and Ross that took place from January 2009 to the end of 2012 for $302,208, prosecutors said. Maccone agreed to settle the allegations that he made the unnecessary billings from November 2007 to the end of 2011 for $818,091.33.

The investigation started after Rosemarie Hennessey, a receptionist at the East Islip doctor's office, filed a complaint, prosecutors said. As a private individual who uncovered fraud against the federal government and filed a federal suit on behalf of the United States, Hennessey may receive a share of the money, prosecutors said.

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