Insurance Fraud NEWS
Indian-American doctor in California pleads guilty to health care fraud
March 27, 2019, San Jose, CA
An Indian-American doctor from in California’s South Bay area pleaded guilty to illegal distribution of pain killers and health care fraud.
Venkat Aachi pleaded guilty to distributing hydrocodone outside the scope of his professional practice and without a legitimate medical need, and to health care fraud, announced United States Attorney for the Northern District of California David L. Anderson and other law enforcement officials March 26, in San Jose, California.
On October 9, 2018, a federal grand jury indicted Aachi and charged him with six counts of distributing drugs outside the scope of professional practice, and one count of health care fraud, Aachi pleaded guilty to one count under each type of charge. The guilty plea was accepted by the U.S. District Judge Edward J. Davila.
According to the plea agreement, Aachi, 52, of Saratoga, was a licensed physician in the state of California who operated a pain clinic in San Jose. He maintained a DEA registration number authorizing him to prescribe controlled substances.
Aachi admitted that from September 18, 2017, through July 2, 2018, he wrote hydrocodone-acetaminophen prescriptions that were outside the scope of his professional practice and not for a legitimate medical purpose.
The plea agreement describes transactions Aachi carried out. For example, in November of 2017, he wrote a prescription by which a patient could get 90 hydrocodone-acetaminophen pills. Aachi did not conduct a physical examination of the patient nor discuss the patient’s pain or response to prior medication.
Aachi acknowledged that he knew the prescriptions were not for a legitimate medical purpose and that he did not write the prescriptions in the usual course of his professional practice.
In addition, Aachi admitted that on July 2, 2018, he submitted a false and fraudulent claim to an insurance company for payment for healthcare benefits, items, and services. Aachi admitted he acted with the intent to defraud the insurance company, the press release from the U.S. Attorney’s Office says.
Aachi remains free on bail pending sentencing. Judge Davila scheduled Aachi’s sentencing hearing for July 1, 2019.
Aachi faces a maximum sentence of 20 years in prison and a fine of $1,000,000 for the illegal distribution of hydrocodone count and 10 years in prison and a $250,000 fine for the health care fraud count, the press release said. Additional fines, restitution, and additional periods of supervised release also could be ordered at sentencing, the press release said.
Source: News India