Pagidipati’s Physician Partners LLC Named as Defendant in Large Scale Medicare Fraud Lawsuit

By  //  April 15, 2021

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In the ongoing lawsuit against Sidd Pagidipati’s CEO of Physician Partners LLC (PPL) in one of Florida’s largest Medicare fraud incidents, prosecuting company National Diagnostic Solutions has pushed for the review of state and local government jurisdictions and laws to ensure similar events can be prevented in the future. 

As the lawsuit pushes forward since it first came to life in 2015, several companies have reviewed transactions and business previously conducted with PPL. Prosecuting company, National Diagnostics Solutions (NDS) former CEO, Keith Fernandez filed a lawsuit against PPL and sister companies Freedom Health and Optimum Healthcare after Fernandez uncovered that these companies are involved in large-scale Medicare fraud.

In May 2015, NDS was solicited by PPL to provide and perform ultrasound screenings to its then 22,000 Medicare Advantage patients.

PPL allowed NDS and HealthFair, a secondary diagnostic testing company, to provide ultrasounds to its patients through their network of primary physicians in Florida. In an official statement, PPL was found to have used its stationary envelopes to mass mail patients, acting as their primary health care doctors.

These actions allowed PPL and HealthFair to conduct thousands of false-positive indiscriminate tests. These activities led to thousands of patients imploring their local physicians about the sudden urge to conduct ultrasounds.

HealthFair managed to test roughly 12,000 patients via its mobile busses within PPL’s network. During the filing of the lawsuit, a statement was released revealing the severity of the false-positive testing conducted by the involved parties and how it can affect patients’ health negatively.

In addition to being actively involved with the lawsuit against PPL, HealthFair was served a formal complaint by the consumer advocacy group Public Citizen on several main claims; that widespread testing and screening of asymptomatic patients can cause more harm than promote better health and the incitement of fearmongering on healthy and asymptomatic patients- further explored below.

The Health Risks of Ultrasound Testing 

Some of the biggest health concerns regarding the unnecessary ultrasound testing included radiation exposure and the associated risk for cancer.

Additionally, screening in low-risk patients is not at all recommended by any health entity in the U.S., and finally, the cost of testing can quickly become a burden for many patients.

Consumer advocacy research has revealed that the involved parties who urged thousands of patients to undergo screening and resulted in false-positive cases have led to increased anxiety and costly diagnostic procedures for the treatments.

PPL, Freedom Health, Optimum HealthCare, and HealthFair were purposefully scheming thousands of patients, enabling a sudden surge in risk scores and reimbursements for patients. Fernandez mentioned that PPL urged NDS to make use of their approved diagnostic codes, and amending final test reports with certain ICD Codes. This resulted in Fernandez only growing his suspicions, as a source close to the incident mentioned that NDS received payments via Pagidipati’s personal American Express credit card.

Former CEO, Fernandez, and NDS managed to quickly steer clear from any negative involvement, as he found flaws in the communication between the companies, and more so, regarding concerns over the compliance with certain Federal Laws. NDS ended its contract and relationship with PPL in November 2015, after NDS found that the two companies could not decide on an agreed submission of encounter and claims data. The company would then later on go to file a lawsuit against the involved defendant.

A Final Take: Exploring the Petitioner Company

National Diagnostic Solution or NDS is a healthcare start-up focused on diagnostic imaging was founded in 2014 by former CEO, Keith Fernandez. The start-up was located in Florida and managed to work with more than 100 local physicians and health care providers.

Since its founding, the company has now spread its influence across the United States, offering advanced diagnostic imaging and neuro-imagine testing solutions to hundreds of practices. NDS has built close ties with healthcare organizations, allowing them to become a leader in mobile-based testing to ensure convenient testing can be conducted in the comfort of the ordering physician’s office. Fernandez has since its founding stepped down as CEO in 2019 to pursue a different career path.