CINCINNATI — A medical fraud trial is underway for doctors of a local imaging clinic accused of ordering medically unnecessary CT scans.

Opening statements began Tuesday in the trial in Cincinnati’s U.S. District Court against Peter Tsai, 45, owner of Advanced Family Medical Center in Coal Grove, his father and mother, Tahsiung Tsai, 73, and Ruey Tsai, 67, who owned Watkins-Tsai Imaging, and Peter Tsai’s cousin, Wei Lih Sheih, aka “Wendy”, 44, who worked for both clinics.

The four were indicted by a federal grand jury in June 2013, about two years after federal agents and local law enforcement raided the clinic and seized medical records to investigate allegations of Medicare and Medicaid fraud.

The defendants were alleged to have performed diagnostic CT scans that were medically unnecessary, including multiple scans of the same body part for the same patient weeks apart.

They are also accused of performing and billing for CT scans related to medically unnecessary injections for purported piriformis syndrome, a problem affecting muscles in the back, and ignored and/or stopped documenting statements and complaints from patients that the injections were not working or were not wanted. The indictment also accuses them of illegally importing adulterated Synvisc from other countries including Canada and Turkey and billing government insurance programs for the injections and transferring money into an account in a Canadian financial institution in order to buy the product.

All four defendants are charged with conspiracy, which is punishable by a sentence ranging from probation to 10 years in prison. Peter Tsai, Tahsiung Tsai and Ruey Tsai are also charged with health care fraud, a crime also punishable by up to 10 years in prison. Peter Tsai is also charged with smuggling, a crime punishable by up to 30 years in prison and money laundering which is punishable by up to 20 years in prison.

The indictment also seeks forfeiture of all proceeds they received as a result of the conspiracy.

Following the indictment, Peter and Tahsiung Tsai voluntarily signed orders to surrender their medical licenses.