Allegiant Experts
Jan 31, 20193 min
Being based in the wonderful state of Florida has many benefits. Among them is the warmth and sunshine we get to experience when our friends up north are enduring cold and snowy weather.
Now, as clinical experts, the Allegiant Experts team pays close attention to the many instances of health care fraud that occur all throughout the United States. But, as Floridians, we can’t help but pay special attention to our state’s cases. And, of course, Florida is not immune to having its fair share of fraudsters.
Yesterday, the Middle District of Florida branch of the United States Department of Justice announced that a Clearwater doctor has been sentenced to prison for her role in a health care fraud scheme. 66 year-old Krishna Iyer will serve six months in a federal prison, pay over $52,000 in health care fraud proceeds and also pay restitution to the Medicare and Medicaid programs.
According to the DoJ report, Iyer has also been
ordered to forfeit her Florida medical license. This will permanently exclude
her from participating in Medicare and Medicaid programs. In addition, Iyer
agreed to surrender her DEA registration number and not reapply for it for at
least 20 years. She had previously used the number to prescribe controlled substances.
The owner and operator of the pain management clinic,
Creative Medical Center in Clearwater, Iyer used her position to write
prescriptions for such controlled substances as oxycodone, morphine and
fentanyl. Her scheme to defraud Medicare, says the report, was carried out
between July 2011 and December 2017. It entailed billing Medicare for face-to-face
visits with patients when, in fact, they had never visited her office.
“Instead, family members of patients had visited
Iyer’s office, where she issued prescriptions for Schedule II controlled
substances, including oxycodone, to the family members in the patients’ names,”
the DoJ report explains, “Iyer thereby violated a Florida law requiring doctors
to perform an in-person office visit and examination of each patient before
issuing Schedule II controlled substance prescriptions.”
They included vital statistics that made it appear
as if her patients had been present in her office for office visits when they
had not. In total, Iyer submitted at least $52,000 in false and fraudulent
Medicare and Medicaid claims.
While this case may appear small and insignificant
when compared to the many other instances of health care fraud in our country,
it is notable that it falls into the “opioid crisis” category. Regardless of
the relatively small amount of money Iyer fraudulently billed for, she is
guilty of worsening an epidemic in the United States.
The DoJ points out that Iyer’s case was investigated
by the Opioid Fraud and Abuse Detection Unit, which is “one of 12 Department of
Justice pilot programs created to help combat the opioid crisis that is
ravaging families and communities across America. The unit focuses specifically
on opioid-related health care fraud using data to identify and prosecute
individuals that are contributing to the prescription opioid epidemic.”
At Allegiant Experts, we remain committed to battling the opioid crisis by providing clinical expertise to attorneys trying such health care fraud cases. For more information about how we may be able to help your case, please don’t hesitate to call us at 407-217-5831 or email us at info@allegiantexperts.com.
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