DFW Nurse Practitioner Sentenced to 20 Years for $52 Million Healthcare Conspiracy
A nurse practitioner was sentenced to 20 years in federal prison and ordered to repay $52 million for his role in a scheme to steal physicians’ identities and defraud Medicare and other insurers.
The Waxahachie provider, Trivikram Reddy, pleaded guilty to committing wire fraud in October 2020 and was sentenced last month. The fraud deceived major insurers—including Medicare, Blue Cross Blue Shield of Texas, Aetna, UnitedHealthcare, Humana, and Cigna—by creating false patient bills using the provider numbers of six doctors. All the claims were false. In early June 2019, federal agents investigated the clinic and found Reddy’s staff manufacturing medical records. Reddy closed his clinic immediately after the encounter.
“Mr. Reddy’s scheme defrauded multiple companies and put the professional reputation of six doctors in jeopardy—all to line his own pockets,” said Dallas FBI Special Agent in Charge Matthew DeSarno via release. “Along with our law enforcement partners, the FBI will continue to root out fraud in the healthcare industry and protect the public from illegal schemes.”
The following week, Reddy made the first of several wire transfers totaling more than $55 million between his accounts. A federal investigation connected the funds to the fraudulent claims submitted by Reddy. When federal agents requested medical records to justify millions in Medicare claims between 2014 and 2019, Reddy and his staff spent four months creating fake documents to give to authorities. At the time, Reddy operated three medical clinics in the area, including Waxahachie Medical, Texas Care Clinics and Vcare Health Services.
Read more: https://www.dmagazine.com/healthcare-business/2021/06/dfw-nurse-practitioner-sentenced-to-20-years-for-52-million-healthcare-conspiracy/
