Source: US FBI
BOSTON – A Geneva, Ill., man has been charged and has agreed to plead guilty in connection with an alleged fraud scheme to defraud Medicare of over $2 million by submitting claims for durable medical equipment (DME) that was medically unnecessary, not wanted by the Medicare beneficiaries and tainted by kickbacks.
Kartik Bhatia, 36, was charged with one count of conspiracy to commit health care fraud and one count of making false statements. A plea hearing has not yet been scheduled by the Court.
According to the charging documents, Bhatia allegedly worked with Raju Sharma, and other co-conspirators to own and operate a DME company that paid telemarketing companies for DME orders for orthotics such as ankle, wrist, knee and back braces. Often, the Medicare beneficiaries did not need or want the braces the defendants shipped them and, as further alleged in the information, the doctors whose signatures appeared on these DME orders often did not treat these beneficiaries and did not prescribe the DME. After the Centers for Medicare and Medicaid Services issued a payment suspension to Bhatia’s DME company, Bhatia simply opened a new DME company that engaged in the same conduct. Bhatia has agreed to plead guilty to health care fraud conspiracy for his alleged role in the scheme as well as false statements in connection with a materially false, fictitious and fraudulent statement and representation that he made to law enforcement during the investigation.
The charge of conspiracy to commit health care fraud provides for a sentence of up to 10 years in prison, up to three years of supervised release and a fine of up to $250,000 or twice the gross gain or loss, whichever is greater. The charge of false statements provides for a sentence of up to five years in prison, up to three years of supervised release and a fine of up to $10,000. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and statutes which govern the determination of a sentence in a criminal case.
United States Attorney Leah B. Foley; Roberto Coviello, Special Agent in Charge, Health and Human Services-Office of Inspector General; and Ted E. Docks, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division made the announcement today. Assistant U.S. Attorneys Lauren Graber and Sarah Hoefle of the Criminal Division are prosecuting the case.
The details contained in the charging document are allegations. The defendant is presumed to be innocent unless and until proven guilty beyond a reasonable doubt in the court of law.