Indiana – A doctor from northwest Indiana who used to run a specialized clinic will serve more than eight years in federal prison after confessing to a large healthcare fraud operation that cost insurers and patients millions of dollars.
Bethany A. Cataldi, 54, was given a 97-month prison sentence by U.S. District Court Judge Gretchen S. Lund. U.S. Attorney Adam L. Mildred said that the punishment comes after she pleaded guilty to healthcare fraud. Cataldi has to serve one year of supervised release and pay back $19,138,245.43 in restitution, in addition to his prison time.
Federal officials alleged that Cataldi, an osteopathic doctor and the sole owner of the Center for Otolaryngology and Facial Plastic Surgery in Highland, repeatedly charged Medicare and private insurance companies for balloon sinuplasty treatments that were never done. The goal of balloon sinuplasty is to ease chronic sinusitis by putting a tiny balloon catheter into blocked sinus passages to open them up and drain them.
According to the Department of Justice, Cataldi wanted about $50 million back for thousands of these treatments. In the end, she got around $20 million in payments. About $460,000 of that comes directly from patients through co-insurance payments.
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As part of her plea agreement, Cataldi agreed to surrender substantial assets obtained with the proceeds of the fraud. Jewelry, cars, musical instruments, and money in several bank accounts are some of those items. She also agreed to sell real estate and other expensive items bought with the money she made illegally to help pay back what she owed.
U.S. Attorney Mildred said physicians who participate in federal healthcare programs hold positions of trust.
“Doctors who sign up with Medicare and private insurance companies are in a position of trust. Bethany Cataldi abused that trust – as well as the trust of her patients, many of whom were senior citizens – by filing fraudulent claims. This sentence reflects that doctors who engage in such outrageous behavior will face significant consequences in this District,” said United States Attorney Adam L. Mildred in the press release.
“My thanks to our federal law enforcement partners whose excellent and determined work led to the sentence that was handed down today.”
Mario M. Pinto, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General, described the scheme as a profound breach of professional responsibility.
“This scheme siphoned millions of dollars from Medicare and private insurers and even targeted individual patients for payment. We remain committed to working with our law enforcement partners to uncover health care fraud and ensure that those who exploit patients and federal programs are held fully accountable,” Pinto said.
The U.S. Department of Health and Human Services Office of Inspector General and the FBI investigated the case, with help from the Food and Drug Administration’s Office of Criminal Investigations. Assistant U.S. Attorney Francis Sohn handled the prosecution.
