At least one Indian and two Indian-origin persons were among 193 medical professionals charged by the US for their alleged participation in massive health care fraud schemes involving approximately USD 2.75 billion in intended losses and USD 1.6 billion in actual losses, the Justice Department has said.
The Justice Department on Thursday announced the 2024 National Health Care Fraud Enforcement Action, under which criminal charges were filed against 193 defendants, including 76 doctors, nurse practitioners, and other licensed medical professionals in 32 districts across the US.
The fraud schemes for which the people were charged involved “approximately USD 2.75 billion in intended losses and USD 1.6 billion in actual losses,” the department said in an official statement.
The government seized over USD 231 million in cash, luxury vehicles, gold, and other assets, it said.
Dr Vijil Rahulan, 52, of Hyderabad, was charged with conspiracy to commit health care fraud and health care fraud in connection with an alleged scheme to fraudulently obtain over USD 82 million in Medicare funds.
“Rahulan caused the submission of false and fraudulent claims for durable medical equipment and genetic testing that were medically unnecessary or otherwise ineligible for reimbursement through Medicare because they were not the product of a doctor-patient relationship and examination,” according to the case summary. The indictment further alleged that his fraudulent conduct resulted in over USD 28.7 million being paid by Medicare. Jaspreet Jagpal, the owner of One World Therapy, was charged with insurance fraud and an enhancement for aggravated white-collar crime in connection with billing for behavioural analysis services not rendered to five minor children. The 34-year-old’s fraudulent scheme caused a loss of approximately USD 166,755.50 over ten months, the case summary said.
As alleged in the complaint through which he was charged, the California resident claimed that behavioural analysis services were provided to minor children that never occurred.
Rama Prayaga, 59, a psychiatrist with offices in northern Virginia and the District of Columbia, was charged by criminal complaint with healthcare fraud in connection with a USD 27.1 million scheme to defraud health insurance companies.
The case summary said that Prayaga, of Virginia, allegedly used billing codes associated with longer, moderately complex patient visits to bill for negligible telemedicine patient encounters, some of which lasted less than a minute. This overbilling resulted in his billing insurance companies for “impossible days” – i.e., billing more than 24 hours a day. Prayaga also pushed medically unnecessary transcranial magnetic stimulation treatments on patients, which were administered either by him or his untrained staff members. He also pushed ketamine treatment, which his staff administered to patients mixed with soda. “Prayaga was paid over USD 14.8 million based on the false and fraudulent claims,” it said. The Justice Department said that the charges filed under the 2024 National Health Care Fraud Enforcement Action include “over USD 900 million fraud scheme committed in connection with amniotic wound grafts; the unlawful distribution of millions of pills of Adderall and other stimulants by five defendants associated with a digital technology company and an over USD 90 million fraud committed by corporate executives distributing adulterated and misbranded HIV medication.” The charges also included “over USD 146 million in fraudulent addiction treatment schemes; over USD 1.1 billion in telemedicine and laboratory fraud; and over USD 450 million in other health care fraud and opioid schemes.”
