Indian American Doctor, 2 Others Accused of Healthcare Fraud

Three persons, including a doctor of Indian descent, have been charged in the United States for participating in a healthcare kickback scheme, the Department of Justice said on Feb. 8.

According to the indictment, Padmini Nagaraj, 60, Muhammad Kaleem Arshad, 62, and Joseph A. Haynes, 61, from Louisiana have been charged with one count of conspiracy to receive illegal health care kickbacks and three counts of receiving illegal health care kickbacks. Arshad and Nagaraj were also charged with one count of conspiracy to commit health care fraud and five counts of health care fraud, the Department of Justice said.

While Arshad specialized in geriatric and addiction psychiatry, Nagaraj specialized in forensic psychiatry. Haynes worked as a marketer and allegedly assisted in negotiating and getting bribes as well as kickbacks for the doctors.

The indictment said that from around September 2010 until April 2015, Arshad, Nagaraj and others conspired among each other to execute a scheme to defraud a healthcare benefit program that affected the finances of the program.

Nagaraj and Arshad treated psychiatric patients at outpatient facilities and were permitted to refer these patients, including medical beneficiaries, to home health agencies (HHA). Haynes, who frequently worked in the outpatient facilities, interacted with these patients. Together they attempted to allegedly enrich themselves through this referral process and entered into a kickback and bribe arrangement with HHAs.

The HHAs are said to have paid bribes and kickbacks to Arshad, Nagaraj and Kim Richard, an associate of Haynes, in exchange for referring Medicare Program beneficiaries, a federal healthcare program, to HHAs. They would, in turn, provide medically unnecessary home health care services to these Medicare beneficiaries and submit claims for reimbursement to Medicare.

Haynes helped in assisting and negotiating kickbacks and bribe arrangements with different HHAs, including Progressive HHA, in return for Arshad and Nagaraj referring and certifying Medicare beneficiaries from the outpatient facilities to HHAs for home healthcare services, according to the document.

“The purpose of the conspiracy was for defendants Arshad, Nagaraj and their co-conspirators to unlawfully enrich themselves,” said the indictment. They referred patients to home healthcare that was not medically necessary for psychiatric patients who were not homebound so that HHAs, like the Progressive in the Louisiana could submit false and fraudulent claims to Medicare. They also diverted the proceeds of the fraud for their personal use and benefits, it added.

“Nagaraj and Arshad fraudulently certified and recertified the Medicare beneficiaries regardless of the beneficiaries’ needs, homebound status, functional limitations or diagnoses,” the indictment added.