Indian-American nurse practitioner gets 20 years jail in USD 52 million healthcare fraud

An Indian-American nurse practitioner has been sentenced to 20 years in jail and ordered to repay over USD 52 million in restitution for his function in a healthcare fraud scheme in the US.

Trivikram Reddy, 39, pleaded responsible to conspiracy to commit wire fraud in October 2020, in accordance with Performing US Lawyer for the Northern District of Texas Prerak Shah. He had been accused of participating in a scheme to defraud Medicare and personal insurance coverage suppliers and was sentenced on Might 25.

In line with court docket paperwork, Reddy, a licensed nurse practitioner, devised a scheme to defraud Medicare, Blue Cross Blue Protect of Texas, Aetna, UnitedHealthcare, Humana and Cigna.

Prosecutors mentioned Reddy created fraudulent affected person payments through the use of the supplier numbers of six physicians because the treating physicians on the claims, regardless that they didn’t carry out the companies.

In June 2019, federal brokers investigated considered one of Reddy’s medical clinics and located his employees manufacturing medical data. After the investigation, Reddy closed the clinic and terminated his enterprise entity.

Just a few days after Reddy closed the clinic he made the primary of a number of wire transfers, which totalled greater than USD 55 million, prosecutors mentioned. An evaluation on the wire switch tied the cash to the fraudulent healthcare claims.

Federal brokers additionally across the identical time interval requested medical data to justify Medicare claims paid between January 2014 and June 2019, and Reddy and his employees allegedly spent the 4 months manufacturing faux medical data to show over to authorities.

Reddy pleaded responsible to wire fraud in October 2020.

“When nurse practitioner Trivikram Reddy stole the identities of physicians to defraud Medicare and different insurers to counterpoint himself, he violated the essential belief that the general public extends to healthcare professionals,” mentioned Miranda Bennett of the HHS Workplace of Inspector Normal Dallas regional workplace.

“As we speak’s sentence sends a message to deprave medical professionals that legislation enforcement will do every thing potential to root out all types of waste, fraud and abuse in our federal healthcare programmes.”

Reddy operated three medical clinics, Waxahachie Medical, Texas Care Clinics and Vcare Well being Service.

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