A Medical Assistant Has Been Charged With Treating Patients Without A License and Falsifying Billings To Medicare

NEWARK, N.J. – A federal grand jury has indicted a medical assistant for a pair of large medical services companies with offices in New Jersey and New York who allegedly posed as a doctor and treated patients without a license, U.S. Attorney Paul J. Fishman announced.

Mario Roncal, 60, of Woodland Park, N.J., is charged with one count of conspiracy to commit health care fraud. Roncal surrendered this morning to special agents of the FBI in Newark and is expected to appear before U.S. Magistrate Judge Cathy L. Waldor this afternoon in Newark federal court.

According to the Indictment returned March 2, 2012, and unsealed today:

Roncal has a medical degree from San Juan Bautista School of Medicine in San Juan, Puerto Rico, but is not licensed to practice medicine in New Jersey, New York, or any other state. Roncal is ineligible under New Jersey law to obtain a medical license in New Jersey because San Juan Bautista School of Medicine is not properly accredited and he lacks certain requirements for international medical students.

From approximately 2004 through 2008, Roncal was employed as a medical assistant at a pair of companies owned and run by the same chief executive officer. Cardio-Med Services, LLC (“Cardio-Med”), provided cardiology, internal medicine, and other outpatient medical services to individual patients and had offices in Union City, Paterson and West New York, N.J. Comprehensive Healthcare & Medical Services, LLC (“Comprehensive Healthcare”), provided the same services in New York and Queens, N.Y.

Roncal conspired to commit health care fraud with the company’s CEO over a four-year period.

When working at Cardio-Med and Comprehensive Healthcare, Roncal held himself out to fellow employees and to patients as “Dr. Roncal.” He examined new patients as well as the CEO’s follow-up patients and ordered diagnostic tests. Roncal also diagnosed patients with medical conditions and diseases and prescribed courses of treatment, including surgery.

Roncal also falsified the accompanying medical records to create the illusion that the medical services were being provided by the companies’ CEO, a licensed physician and board-certified cardiologist. At the direction of the CEO and otherwise, Roncal forged the CEO’s signature on all paperwork associated with his unlawful services, including on prescription pads and patient charts. Roncal and the CEO enriched themselves by submitting the false billing claims to Medicare.

The count with which Roncal is charged carries a maximum potential penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.

U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Michael B.Ward; the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Thomas F. O’Donnell; the United States Postal Inspection Service, under the direction of Postal Inspector in Charge Philip R. Bartlett; the Social Security Administration, Office of the Inspector General, under the direction of Special Agent in Charge Edward J. Ryan, New York Field Division; and IRS – Criminal Investigation, under the direction of Acting Special Agent in Charge JoAnn S. Zuniga, with the investigation leading to the Indictment. He added that the investigation is ongoing.

The government is represented by Scott B. McBride of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.

The charges and allegations contained in the Indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty.