Striking a Nerve

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40085207 - medicine cost - stethoscope,pills,ampules and syringe over a stack of dollars toned in blue

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Pain can be debilitating. (Thankfully, there are a variety of methods available for treating chronic and acute ailments.) A Department of Justice press release tells about how a physician specializing in interventional pain management and his psychiatrist wife used a specific pain treatment technique to falsely bill multiple government programs for $2.5 million in procedures that were not performed. (Let’s just say that this couple’s illegal activities definitely struck a nerve with the government.)

The story states that the man and wife owned and operated a Maryland pain management center where a nerve block procedure was used to treat their patients’ pain. (A nerve block is a pain management technique where an anesthetic is injected into an affected nerve area interrupting the flow of pain signals to the brain.)

Apparently, they filed claims for procedures they did not perform with a machine that did not exist. They altered or destroyed patient files to cover up the fact that there was no machine to help verify needle placement. (Sounds like a pretty scary machine if you ask me.) Sometimes they did perform less expensive procedures, but billed for more expensive treatments so they could receive a higher reimbursement. (The couple had a heyday submitting bills over more than three years to multiple government-funded insurance programs including Medicare, Medicaid, TRICARE, Federal Employees Health Benefits and the Office of Workers’ Compensation.)

After an eight-day trial, a federal jury convicted the licensed 60-year-old physician and his 57-year-old wife, who was also licensed. The husband is facing more than 120 years in prison for health care fraud, making false statements related to a health care program, obstruction of justice, wire fraud and aggravated identity theft. The wife was convicted on the same charges plus obstructing an audit. She is facing more than 130 years in prison. (It’s safe to assume that they are really in a lot of trouble.)

There’s no doubt that these two fraudsters are sitting on pins and needles as they await their sentencing. As far as I know there is only a cell block, not a nerve block waiting for them when they get to prison. The type of pain that they are about to experience is a pretty bad side effect of committing a crime.

Source: Today’s ”Fraud of the Day” is based on ”Doctors Convicted in $2.5 Million Health Care Fraud Scheme,” issued on September 4, 2015.

Greenbelt, Maryland – A federal jury convicted two doctors, Paramjit Singh Ajrawat, age 60, and his wife, Sukhveen Kaur Ajrawat, age 57, both of Potomac, Maryland, on charges related to their health care fraud scheme. Paramjit Singh Ajrawat was convicted of one count of health care fraud, two counts of making a false statement related to a health care program, one count of obstruction of justice, four counts of wire fraud, and one count of aggravated identity theft. Sukhveen Kaur Ajrawat was convicted of one count of health care fraud, four counts of making a false statement related to a health care program, one count of obstruction of justice, four counts of obstructing an audit, four counts of wire fraud, and two counts of aggravated identity theft. The convictions are in connection with the pain clinic they owned and operated.

The convictions were announced by United States Attorney for the District of Maryland Rod J. Rosenstein; Special Agent in Charge Robert Craig of the Defense Criminal Investigative Service – Mid-Atlantic Field Office; Special Agent in Charge Nicholas DiGiulio, Office of Investigations, Office of Inspector General of the Department of Health and Human Services; Special Agent in Charge Drew Grimm, Office of Personnel Management, Office of Inspector General; Special Agent in Charge Kevin Perkins of the Federal Bureau of Investigation; Special Agent in Charge Steven Anderson, of the Washington Regional Office, U.S. Department of Labor – Office of Inspector General, Office of Labor Racketeering and Fraud Investigations; and Special Agent in Charge Paul L. Bowman of the U.S. Postal Service, Office of Inspector General.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.