Bethany Cataldi: The Case of the Missing Sinus Procedures

The $50 Million Sinus Scheme

For years, Dr. Bethany A. Cataldi ran an ear, nose, and throat practice in Highland, Indiana. Patients came to the Center for Otolaryngology and Facial Plastic Surgery looking for answers about sinus problems, breathing issues, and related conditions. They trusted that the care listed in their medical records was real. They trusted that their insurance was being billed honestly. They trusted that the doctor-patient relationship meant something.

Federal prosecutors say that trust was broken.

According to the U.S. Attorney’s Office for the Northern District of Indiana, Dr. Cataldi billed Medicare and private insurers for thousands of balloon sinuplasty procedures that she did not perform. Balloon sinuplasty is a real procedure used to treat chronic sinusitis by widening and draining blocked sinus passages. But prosecutors said Dr. Cataldi billed for procedures that never happened.

A Practice Built Around Trust

Most patients do not study every line of a medical bill. They do not know every billing code. They may not know what an insurer paid, what Medicare paid, or whether a device listed in a claim was actually used.

They rely on the doctor.

That is part of what makes this case so alarming. According to federal prosecutors, Dr. Cataldi sought approximately $50 million for non-existent balloon sinuplasty procedures and was paid nearly $20 million. She was sentenced to 97 months in prison and ordered to pay more than $19 million in restitution.

The Times of Northwest Indiana reported that the scheme lasted eight years and involved Medicare, private insurers, and patients. The Times also reported that Dr. Cataldi had agreed to pay restitution connected to Medicare, private insurance companies, and patients who sustained financial losses.

The Inventory Did Not Add Up

One of the most striking details reported about the case involves the devices used for balloon sinuplasty procedures.

The Times reported that Dr. Cataldi was accused of submitting more than 1,500 claims to Medicare for reimbursement on balloon sinuplasty and inflation devices between March 2015 and December 2023, despite purchasing far fewer devices during that period. According to The Times, records from a medical device manufacturer showed that Dr. Cataldi purchased approximately 100 of each device from that company between 2015 and 2023.

In other words, the case was not just about complicated billing codes. It was about whether the procedures being billed could have been performed at the volume claimed.

Patients May Have Paid Out of Pocket

This was not only an insurance-company problem.

Federal prosecutors said approximately $460,000 of the fraudulently obtained funds came directly from individual patients through co-insurance payments. The Times separately reported that more than $550,000 was connected to patients who owed co-pays through private insurance providers, based on the plea.

For former patients, that raises deeply personal questions.

• ‍Did they pay for something that never happened?
• Were they told a procedure was performed when it was not?
• Were their medical records accurate?
• Did their actual medical condition go untreated?
• Were decisions about their care influenced by billing rather than medical need?

These questions go to the heart of the relationship between a patient and a doctor.

The Court Called It a Violation of Trust

At sentencing, The Times reported that U.S. District Court Judge Gretchen Lund said, “Both patients and third-party medical insurers trust that doctors will tell them the truth and do no harm,” and that Dr. Cataldi violated that trust.

Federal prosecutors echoed that concern. The DOJ said Dr. Cataldi abused the trust of her patients, many of whom were senior citizens, by filing fraudulent claims.

That is what makes the story bigger than a billing case. It is about patients who may now be left wondering what happened inside an exam room, what happened inside their medical file, and what happened after a claim was submitted in their name.

Investigating Claims for Former Patients

CohenMalad, LLP’s medical malpractice team is investigating potential claims related to Dr. Cataldi’s conviction.

We are speaking with former patients of Dr. Cataldi who were or may have been victims of fraud, malpractice or other injustices. Our team is helping former patients understand how they may have been affected by Dr. Cataldi’s scheme and whether they may have legal rights.

Former patients may have questions about medical bills, insurance statements, co-insurance payments, sinus procedures, medical records, follow-up care, or whether their health was affected. CohenMalad, LLP can help review those concerns.

Indiana Medical Malpractice Attorneys Fighting for You

If you or a loved one was treated by Dr. Bethany A. Cataldi or the Center for Otolaryngology and Facial Plastic Surgery in Highland, Indiana, contact CohenMalad, LLP for a free, confidential, no-obligation case review.

Our medical malpractice attorneys can help you understand your legal rights and determine whether you may have been affected by Dr. Cataldi’s scheme, call 317.636.6481 or request a confidential medical case review online now.

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