Kendall companies and doctors pay $810,000 to settle Medicare fraud charges

David J. Neal, Miami HeraldMiami Herald

Just over $810,000 brought an end to a five-year federal court civil case in which a Kendall radiology center and some of its doctors were accused of Medicare fraud.

The settlement agreement allows Vascular and Interventional Specialists, Vascular and Spine Institute, Dr. Oscar Sosa and Dr. Osmany DeAngelo to continue to deny admitting to charging Medicare for unnecessary angioplasty procedures from Jan. 1, 2015, through Sept. 30, 2019.

But the two companies — which state corporate records say are run by Sosa, Gary Tie-Shue and Peter Clayton out of 9175 SW 87th Ave. — and the two doctors are paying $810,301 to bring this case to a conclusion.

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Sosa has been licensed in Florida since May 2000. According to online state records, Sosa has never faced professional discipline, but state insurance records say his malpractice insurance paid $225,000 after a procedure involving two angioplasties left a patient with a “right foot drop,” which Cleveland Clinic describes as “a symptom in which you drag your toes when you walk due to weakness or paralysis of certain muscles in your foot.”

DeAngelo has been licensed in Florida as an osteopathic physician since May 2004. Although he has no professional discipline history, this isn’t the first time he has faced trouble related to an angiogram. State insurance records say DeAngelo’s malpractice insurance paid $250,000 on Aug. 31, 2021, after his “alleged failure to fully describe findings and recommend additional treatments or transfer” after interpreting an angiogram while at Larkin Community Hospital in South Miami.

This case was originally filed by whistleblower Dr. Emilio Lopez, who provided radiology services at Vascular from Oct. 1, 2018, until Aug. 26, 2019. The False Claims Act allows Lopez to file suit on behalf of the federal government and get a cut of the money recovered. In this case, that share is $186,369.

The flow of blood — and money?

“Angioplasty is a procedure used to open blocked coronary arteries caused by coronary artery disease,” Johns Hopkins Medical Center says. “It restores blood flow to the heart muscle without open-heart surgery.”

Angioplasty is one of the vascular and radiology services offered on an outpatient basis at Vascular, which operated out of 7887 North Kendall Dr. during the 2015-2019 period in question.

The case alleged that Vascular altered patient medical records or lied on patient medical records to make it appear as if various angioplasties were necessary. Lopez’s lawsuit claimed the Vascular management tried to bring him into the alleged scheme on various levels, but he refused.

“On Aug. 23, 2019, [Lopez] again discussed the defendants’ fraudulent practices with Clayton, Sosa, and DeAngelo,” the lawsuit said. “At the meeting, Clayton, Sosa, and DeAngelo offered no explanation for how the surgeries were medically necessary and nonfraudulent. The defendants made it clear to [Lopez] that their practices would continue despite [Lopez’s] repeated protestations.

“On various occasions, Sosa laughed off [Lopez’s] concerns. For example, he stated that if the govenment audited VIS, DeAngelo ‘would be the only one going to jail.’ He also commented that ‘nobody ever has to pay any of the money back.’”