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Physician charged with 38 counts of health care fraud

Danine Anne Rydland is accused of devising a scheme to defraud Medicare, Medicaid, PEIA, and Unicare

July 23, 2010|By MATTHEW UMSTEAD

MARTINSBURG, W.Va. -- A Martinsburg physician has been charged with 38 counts of health care fraud, according to an indictment filed Thursday in U.S. District Court in Martinsburg

Danine Anne Rydland, 54, an obstetrician/gynecologist, is accused of devising a scheme to defraud Medicare, Medicaid, the Public Employees Insurance Agency (PEIA) and Unicare, according to announcement Friday by U.S. Attorney Betsy Jividen.

Rydland owned and operated a medical practice in Falling Waters, W.Va., from June 1, 2004, to Sept. 5, 2008, when the alleged fraud happened, according to Jividen's announcement.

Counts 1 through 14 allege "Rydland fraudulently obtained about $22,000 from Medicare; $59,000 from Medicaid; $3,400 from Unicare; and $2,800 from PEIA as a result of claims for prolonged services that were not rendered and for which there was no documentation of the amount of time spent in face-to-face contact with the patients," according to Jividen's announcement.

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Counts 15 through 26 allege Rydland devised a scheme to defraud Medicare, Medicaid, PEIA and Unicare by filing claims that misrepresented a higher level of office visit or for which no such service was rendered at all, according to Jividen's announcement.

Counts 27 through 38 allege Rydland willfully accepted payment from Medicare, Medicaid, Unicare and PEIA for established patient office visit services that were not rendered, according to the announcement.

Authorities allege she helped prepare and submit inflated claims to those agencies and other third-party payers between June 2004 and September 2008.

In some cases, she allegedly billed for prolonged services that weren't provided or could not document the amount of time spent in direct contact with patients, according to the indictment.

Conviction on each count could carry up to 10 years in prison and $250,000 in fines.

The case was investigated by the U.S. Department of Health and Human Services-Office of Inspector General and West Virginia Medicaid Fraud Control Unit.

The allegations against Rydland come little more than five years after 23rd Judicial Circuit Judge Christopher C. Wilkes in June 2005 awarded a $1.1 million judgment plus interest to a couple who claimed medical malpractice in Rydland's performance of a cryotherapy procedure, according to court records.

In 1998, the West Virginia Board of Medicine placed Rydland on probation for three years after concluding she failed to practice medicine with the level of "care, skill, and treatment recognized by a reasonable, prudent physician engaged in the same specialty as being acceptable under similar conditions and circumstances," according to board's licensee database.

The $1.1 million judgment is among seven cases of malpractice involving Rydland since 1986, according to the state Board of Medicine.

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