Indian-origin physician sentenced to two years in US for engaging in health care fraud scheme

New York, January 7

An Indian-origin physician has been sentenced to two years in prison and ordered to pay fine and restitution of over a million dollars for engaging in a multi-faceted health care fraud scheme and for illegally prescribing thousands of opioid painkillers and muscle relaxers.

Kain Kumar, 56, of California was sentenced by US District Judge Philip Gutierrez of the Central District of California, who also ordered Kumar to pay USD 509,365 in restitution, USD 494,900 in asset forfeiture, and a USD 72,000 fine.

Kumar pleaded guilty in April 2019 to one count of health care fraud and one count of distribution of hydrocodone.

He was sentenced to 24 months in prison and three years of supervised release.

As part of his guilty plea, Kumar admitted that from February 2011 until May 2016, he defrauded the Medicare health care benefit programme by prescribing unnecessary home health services in exchange for the payment of illegal kickbacks to him from a California-based home health agency.

Kumar admitted that he submitted false and fraudulent claims for reimbursement to Medicare for Medicare beneficiaries that he did not personally examine or for patients he only briefly examined.

Kumar also admittedly prescribed drugs that were not medically necessary and which were paid for by the federal health insurance programme.

Kumar admitted that between February 2013 and January 2016, he prescribed 23,826 pills of the opioid drug hydrocodone and 38,459 pills of the muscle-relaxer carisoprodol without a legitimate medical purpose.

Kumar directed his office staff–who were not medical professionals–to issue prescriptions for these drugs to patients even though Kumar had not examined the patients.

Kumar also instructed his office staff to issue prescriptions for opioid drugs by instructing his staff to sign Kumar’s name on prescriptions and by providing his staff with pre-signed prescriptions.

In one instance, Kumar examined a patient only on the very first visit and thereafter on a monthly basis, for approximately a year-and-a-half, he caused prescriptions to be issued to the patient for hydrocodone and carisoprodol, even though Kumar did not actually see the patient for a subsequent physician examination. PTI