North Texas Cares for U.S. Capitol Police Fund


News Update poster

Trivikram Reddy, Ordered to Pay Extra Than $52 Million in Restitution

A Waxahachie nurse practitioner was sentenced yesterday to twenty years in federal jail and ordered to repay greater than $52 million in restitution for his position in a well being care fraud conspiracy, introduced Appearing U.S. Lawyer for the Northern District of Texas Prerak Shah.

Trivikram Reddy, 39, pleaded responsible to conspiracy to commit wire fraud in October 2020. He was sentenced on Tuesday by U.S. District Decide Ada Brown.

“Mr. Reddy engaged in a scheme that defrauded Medicare and personal insurance coverage suppliers out of tens of millions of {dollars},” stated Appearing U.S. Lawyer Shah. “The Justice Division will proceed to aggressively prosecute all kinds of well being care fraud to guard the integrity of our well being care system and be sure that criminals are held accountable.”

Healthcare Fraud Impacts Everybody

“Well being care fraud impacts everybody, it causes billions of {dollars} in losses annually and erodes belief in our well being care system,” stated Dallas FBI Particular Agent in Cost Matthew DeSarno. “Mr. Reddy’s scheme defrauded a number of corporations and put the skilled repute of six docs in jeopardy all to line his personal pockets. Together with our regulation enforcement companions, the FBI will proceed to root out fraud within the well being care business and shield the general public from unlawful schemes.”

“When nurse practitioner Trivikram Reddy stole the identities of physicians to defraud Medicare and different insurers to counterpoint himself, he violated the essential belief that the general public extends to healthcare professionals,” stated Particular Agent in Cost Miranda L. Bennett of the HHS-OIG Dallas Regional Workplace. “Right now’s sentence sends a message to deprave medical professionals that regulation enforcement will do all the things doable to root out all types of waste, fraud and abuse in our federal well being care applications.”

In accordance with courtroom paperwork, Mr. Reddy, a licensed nurse practitioner, devised a scheme to defraud Medicare, Blue Cross Blue Protect of Texas, Aetna, UnitedHealthcare, Humana, and Cigna.

Creating False Affected person Payments

Mr. Reddy and co-conspirators created false affected person payments utilizing the supplier numbers of six docs because the treating physicians on the claims. All of the claims had been false and at no time did the six docs present billable providers to any of Mr. Reddy’s medical clinics.

On June 3, 2019, federal agents served a civil investigative demand at one among Mr. Reddy’s medical clinics. When regulation enforcement arrived on the website, brokers discovered Mr. Reddy’s employees manufacturing medical data. Following the encounter, on June 8, Mr. Reddy closed the clinic and terminated his enterprise entity with the Texas Secretary of State.

On June 13, 2019, Mr. Reddy made the primary of a number of wire transfers which, in sum, totaled greater than $55 million. A forensic monetary evaluation straight tied the cash to fraudulent well being care claims submitted by Mr. Reddy.

Federal brokers requested medical data to justify tens of millions of {dollars} of paid Medicare claims paid between January 2014 and June 2019. Mr. Reddy and his employees spent the subsequent 4 months manufacturing faux medical data to show over to authorities.

This case was investigated by the FBI Dallas Subject workplace and Well being and Human Companies-Workplace of the Inspector Basic (HHS-OIG). Assistant U.S. Lawyer Donna Strittmatter Max and Particular Assistant U.S. Lawyer Matt Smid prosecuted the case.

Supply: Division of Justice


Source link