Canton, Sharon Residents among over 300 Defendants Charged in Nationwide Health Care Fraud Takedown

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A Canton man is one of 324 people charged in what the U.S. Attorney’s Office for the District of Massachusetts has called the largest health care fraud takedown in history, in a nationwide operation with involvement of almost every state, announced the U.S. Attorney’s Office in a press release on Monday, June 30th.

Krishna Gidwani, a 55 year-old resident of Canton, was charged and agreed to plead guilty to health care fraud conspiracy in March of this year, for his role in connection with an alleged fraud scheme to defraud Medicare of over $4 million. He is believed to have submitted claims for unnecessary durable medical equipment (DME) that was unwanted by Medicare beneficiaries and tainted by kickbacks.

U.S. Attorney Leah B. Foley alleges that Mr. Gidwani worked with co-conspirators, including Raju Sharma of Sharon, Massachusetts, to own and operate a DME company that paid telemarketing companies for DME orders comprised of orthotics like ankle, wrist, knee and back braces. Not only were the projects unwanted by beneficiaries, but DME orders contained signatures of doctors who did not treat the beneficiaries nor prescribe the DME.

“Mr. Gidwani is accused of manipulating Medicare to enrich himself – misusing the names of unwitting doctors to push unwanted and unnecessary medical equipment onto elderly patients,” said U.S. Attorney Foley. “Today’s charges are part of a historic, nationwide effort to hold accountable those who abuse federal health care programs for personal gain,” she said.

The 61 year-old Mr. Sharma of Sharon was arrested in February this year. While released on conditions pending trial, a court found him to have violated conditions of his release by contacting a potential witness, for which he was detained again in April.

Mr. Sharma is alleged to have worked with family and acquaintances to open DEM companies, and was paid approximately $15.8 million after allegedly fraudulently billing Medicare approximately $29.6 million for DME orders by using medical practitioners’ national provider identities without their knowledge. The U.S. Attorney also alleges that although Mr. Sharma agreed to pay marketing companies a flat fee for their services, he actually paid them on a per-lead, per-order, basis, in violation of the anti-kickback statute.

With profits from the alleged fraud, the U.S. Attorney says that Mr. Sharma purchased luxury goods that included two Ferraris, a Mercedes-Benz Model S, and at least three Rolex watches that were individually worth tens of thousands of dollars.

Mr. Sharma pled guilty to one count of conspiracy to commit health care fraud, and entered a plea agreement. As a result, the federal government will recommend that a court sentence him to 10 years in prison and more than $15.8 million in restitution. Mr. Sharma has agreed to forfeit both the luxury goods which he allegedly purchased through fraudulently obtained profits and $250,000 cash which investigators seized from his bank accounts.

The charge of conspiracy to commit health care fraud can result in a sentence of up to 10 years in prison, supervised release of up to three years, and a fine of up to $250,000 or twice the gross gain or loss, whichever is greater.

The U.S. Attorney's office says that the 324 defendants were involved in submitting a total of over $14.6 billion in intended loss and over 15 million pills of illegally diverted controlled substances in fraud and illegal drug diversion schemes. The group allegedly defrauded programs meant to care for the elderly and disabled. The federal government has seized over $245 million in cash, luxury vehicles and other assets related to the takedown.

“Health care fraud affects everyone. Not only does it put a strain on our country’s vital health care system, but it costs taxpayers billions of dollars every year,” said Ted E. Docks, Special Agent in Charge of the FBI’s Boston Division.

“Our office will continue to work closely with our law enforcement partners to root out fraud and ensure that Medicare dollars support genuine patient care, not criminal profit,” said U.S. Attorney Foley.



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