Detroit Federal Jury Convicts Three in $14.5 Million Medicare Fraud Scheme

A Detroit-area physician, the owner of a home health agency, and a patient recruiter have been convicted by a federal jury for participating in a $14.5 million scheme to defraud Medicare, according to the Justice Department. Dr. Pramod Raval was found guilty of conspiracy to commit healthcare fraud and conspiracy to solicit or receive healthcare kickbacks for referring patients to two Detroit area home healthcare companies, All American Home Care Inc. and Patient Choice Home Healthcare Inc. Chiradeep Gupta, a physical therapist who is also part-owner of All American, was found guilty of conspiracy to commit healthcare fraud, conspiracy to commit money laundering, and money laundering. Patient recruiter Richard Shannon was found guilty of conspiracy to commit healthcare fraud.

Conspirators Submitted False Claims to Medicare for Physical Therapy Services

The defendants and their co-conspirators caused false and fraudulent claims to be submitted to Medicare through the two home health agencies Oak Park, Michigan-based Patient Choice and All American. The home healthcare companies purportedly provided physical therapy services and skilled nursing to Medicare beneficiaries in the greater Detroit area.

The conspirators paid patient recruiters to locate Medicare beneficiaries to sign blank forms that would allow the conspirators to file false claims with Medicare for physical therapy services that were medically unnecessary and/or were never actually provided. The owners of the two home healthcare companies paid doctors to sign referrals and other documents needed to submit bills to Medicare. Medical records were falsified to make it look like physical therapy services had been provided, when the services had not been rendered.

An additional sixteen individuals who worked at or were connected with Patient Choice and All American have already pleaded guilty.

Whistleblowers Can Be Early Detectors of Medicare Fraud

Medicare fraud is an expensive and widespread drain on the government. We need whistleblowers to come forward with information so that the fraud can be stopped. To encourage whistleblowers to act, the False Claims Act provides that individuals with knowledge of fraud against the government can file suit against the wrongdoers and share with the government in any recovery.

Whistleblowers should know their rights under the False Claims Act. The attorneys at Waters & Kraus have decades of experience in working with whistleblowers and can help you in the process. Email us or call our whistleblower lawyers at 800.226.9880 to learn more about our practice and how we can assist.

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