Indian American Doctor Pleads Guilty to Healthcare Fraud

An Indian American doctor has pleaded guilty to one count of healthcare fraud in the United States. Dr. Jayam Krishna Iyer could be sentenced to 10 years in federal prison, or 20 years if her offense involved serious bodily injury. 

Iyer, 66, accepted her involvement in medical fraud on Sept.18, U.S. Attorney’s Office (USAO) in Middle District of Florida, said in a statement. 

“As part of the plea, Iyer has agreed to surrender both her DEA registration number that she used to prescribe controlled substances and her Florida medical license, and to a permanent exclusion from the Medicare and Medicaid programs,” the statement added. 

Iyer owned and operated Creative Medical Center located in Clearwater, Florida, which functioned as a pain management clinic. She was accused of  billing Medicare and Medicaid for office visits, tests, and services provided to patients using her National Provider Identification (NPI) number, while she didn’t actually examine these patients in person. She also wrote the prescriptions for controlled substances, including oxycodone, without even seeing the patient, which is a violation of law. 

The fraud began at least as early as July 2011, and continued through December 2017, the USAO statement said. 

“Iyer executed and carried out a scheme to defraud Medicare by billing for face-to-face office visits with Medicare beneficiaries, when, in fact, certain patients did not go to Iyer’s office and were not examined by her on the claimed dates,” according to the statement. 

On some occasions, it was the family members of patients who went to Iyer’s office with notes requesting her to issue and provide prescriptions to them, and in the beneficiaries’ names — and Iyer issued those prescriptions.

Florida law requires doctors to perform an in-person office visit and examination of each patient before issuing Schedule II controlled substance prescriptions. 

“Iyer also falsified her electronic medical records, including vital statistics, to make it appear that the actual patient was present in her office for an office visit, when the patient was not. Iyer submitted at least $51,500 in these types of false and fraudulent Medicare claims,” the statement added. 

The  case was investigated by the Opioid Fraud and Abuse Detection Unit. 

In July this year, another India origin doctor, Dr. Bharat Patel, had pleaded guilty to writing unnecessary prescriptions to patients to get monetary benefits. He was charged for running a “pill mill” last year.