Two Indian-Americans were among three people who pleaded guilty to their roles in several Detroit-area health care fraud schemes, the US Justice Department has said.
It said Baskaran Thangarasan, 37, pleaded guilty to one count of conspiracy to commit health care fraud; while Sandeep Aggarwal, 38, pleaded guilty to one count of conspiracy to launder money.
Another individual Wayne Smith, 47, pleaded guilty to one count of conspiracy to commit health care fraud.
At sentencing, Thangarasan, who is a licenced physical therapist, and Smith face a maximum sentence of 10 years in prison and a USD 250,000 fine. Aggarwal faces a maximum sentence of 20 years in prison and a USD 500,000 fine.
According to information contained in plea documents, Thangarasan admitted that he began working in approximately September 2003 as a contract therapist for a co-conspirator, who owned and controlled several companies operating in the Detroit area that purported to provide physical and occupational therapy services to Medicare beneficiaries.
Medicare is a social insurance programme of the US government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria.
Thangarasan admitted him, the co-conspirator and others created fictitious therapy files appearing to document physical therapy services provided to Medicare beneficiaries, when in fact no such services were provided.
According to court documents, the fictitious services reflected in files were billed to Medicare through its sham providers controlled by Thangarasan’s co-conspirators.
He admitted that his role in creating fictitious therapy files was to sign documents and progress notes indicating he had provided physical therapy services to particular Medicare beneficiaries, when in fact he had not.
Thangarasan, who was paid approximately USD 50 by co-conspirators per file that he falsified in this manner, also admitted that in the course of the scheme charged in the indictment, he signed approximately 1,011 fictitious physical therapy files, falsely indicating he had provided physical therapy services to Medicare beneficiaries.
He admitted he knew that the files he helped falsify were used to justify fraudulent billings to Medicare.
In addition, Thangarasan admitted that between approximately September 2003 and May 2006, his co-conspirators submitted claims to Medicare programme totalling approximately USD 5,055,000 for files that were falsified by him. Medicare actually paid approximately USD 2,325,000 on those claims.
Thangarasan admitted he was fully aware that Medicare was being billed for occupational therapy services he had falsely indicated he had performed.
In his plea in the same case, Aggarwal admitted to assisting co-conspirator Suresh Chand in laundering proceeds of Chand’s Medicare fraud scheme.
Chand pleaded guilty in September to conspiracy to commit health care fraud and conspiracy to launder money. He admitted to conspiring to submit about USD 18 million in fraudulent physical and occupational therapy claims to Medicare.
Aggarwal, who admitted to working at Chand’s office, acknowledged that his role in the scheme was to set up sham entities at Chand’s direction, with the purpose of using those entities to distribute the proceeds of the fraud to the various co-conspirators.
According to plea documents, one such entity was called Global Health Care Management Services.
Aggarwal admitted that Global Health Care Management Services, which he helped create, provided no health or management services of any type, but existed solely as a mechanism to conceal the location of fraudulently obtained Medicare proceeds.
Aggarwal admitted in his plea that he and Chand laundered approximately USD 393,000 through this sham entity.