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US: NRI couple convicted in health care fraud case

April 28, 2010 03:16 IST

An NRI doctor couple has been convicted of conspiring to commit health care fraud over a 10-year-period in Texas and will give up millions in assets.

Dr Arun Sharma (56) and Dr Kiran Sharma (54), both from Kemah in Texas, have been convicted of conspiring to commit health care fraud over a 10-year-period in the Southern District of Texas, US Attorney Jose Angel Moreno said on Tuesday.

The doctors were set to begin trial on Monday when they each instead opted to plead guilty to one count of conspiracy and one count of health care fraud.

As per the prosecutors, the couple will be sentenced on July 27. The two were taken into custody on Monday after reaching a plea agreement in Houston.

US Attorney Moreno said the pair conspired to commit health care fraud for medical procedures, mainly related to pain management, that were not done.

Kiran is expected to get eight years in prison. Her husband faces up to 15 years. They are forfeiting assets including multiple properties and more than $ 1.5 million in cash.

In entering their pleas before United States District Judge David Hittner, the couple admitted that from January 1, 1998, through June 10, 2009, they fraudulently billed Medicare, Medicaid and various private health care providers for medical procedures that were not performed.

Specifically, during the time period of the conspiracy, the defendants owned and operated multiple medical clinics operating under the name Allergy, Asthma, Arthritis Pain Center, with two principle locations in Baytown and Webster, Texas, (the clinics).

While some of patients at the clinics were referred by other medical doctors, approximately 50 per cent of the patients came to the clinics through word of mouth. Specifically, Dr. Arun was known as an easy touch for prescribing Hydrocodone, Soma and Xanax.

And, later started even prescribing stronger narcotics such as Oxucodone, methadone and fetynal patches. In addition to the prescription of narcotics, a large part of the practice conducted at the clinics was to provide patients with injections of lidocaine combined with steroids which at times provided temporary relief of various joint and muscle pain.

Although most of the injections given to the patients were, at best, trigger point injections, they were billed to the insurance companies as facet joint injections, paravertebral injections, sacroiliac nerve injections, sciatic nerve injections and various nerve block injections.

Seema Hakhu Kachru in Houston
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