Dr. Rajesh Doshi, a 59-year-old physician in Bloomfield Hills, recently pled guilty in U.S. District Court to single counts of conspiracy to commit healthcare fraud, and health care fraud.
According to prosecutor Niall M. O’Donnell of the Justice Department’s Criminal Division Fraud Section, Doshi admitted to having conspired with others by referring Medicare patients for home health care which was not medically necessary. He also submitted false claims for these services to receive reimbursement from Medicare.
The false claims were apparently submitted through Home Physicians Services (HPS). This is a medical practice in Southfield owned by Doshi himself. However, using the cover of a shell company, Doshi disguised his ownership of HPS because of his prior convictions for similar crimes.
They claimed home visits that never took place
Doshi also admitted to paying kickbacks to recruiters in order to get additional Medicare beneficiaries. He paid the kickbacks for both HPS and other home health agencies owned by co-conspirators involved in the fraud scheme. He and others involved then falsified billing information and medical charts. They claimed home visits that never took place. Sometimes they even claimed complex but fraudulent medical complications requiring intensive home care visits that could be billed for later.
Doshi also admitted to having solicited and received kickbacks from other home health agency owners in return for the referral of Medicare beneficiaries to those agencies. He then provided instruction on how his co-conspirators could falsify documents to receive unearned payments from Medicare as well.
All in all, between October 2005 and September 2012, Doshi and his co-conspirators received more than $19 million dollars as a result of falsified claims and fraudulent medical billing according to the Medicare Fraud Strike Force.
Doshi’s guilty plea is not the first for this group of fraudulent physicians. Three other doctors, along with a physician’s assistant, have already pled guilty for the parts they played in this long-running and very costly criminal enterprise.
Doshi’s sentencing has been scheduled for March 3rd, 2015