Part B Insider (Multispecialty) Coding Alert

Published on Mon May 13, 2013 PDF

Plus: Don’t let email trip up your HIPAA efforts.

When you think of a criminal mastermind, you might be picturing a villain from the latest James Bond movie. But in reality, the government has described a Michigan-based man as just that due to his efforts to defraud Medicare to the tune of $29 million.

Sachin Sharma pleaded guilty on May 3 to conspiracy to commit health care fraud as well as tax evasion for his role billing home health and psychotherapy services that were never provided. Court documents indicate that he paid kickbacks to patient recruiters to get beneficiary information, and then used that information to bill Medicare fraudulently. He also trained employees to fabricate and alter medical records to suggest that certain services were performed when they actually weren’t.

Sharma faces up to 10 years in prison and a $250,000 fine. You can read more about the case at http://www.fbi.gov/detroit/press-releases/2013/leader-of-29.1-million-medicare-fraud-scheme-pleads-guilty-in-detroit