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Ex Doctor Gets 2 Years in Federal Prison for Defrauding Medicare and Illegally Prescribing Opioid Drugs

Posted by Fay Arfa | Jan 07, 2020 | 0 Comments

            A federal judge sentenced ex-doctor Kumar, 56, of Encino to 24 months in federal prison for engaging in a multi-faceted Medicare fraud scheme, and also for illegal prescribing thousands of opioid painkillers and muscle relaxants.Ex-Dr. Kumar also has to pay $1 million, consisting including $509,365 in restitution, $494,900 in asset forfeiture, and a $72,000 fine.

            Kumar pleaded guilty in April 2019 to one count of health care fraud and one count of distribution of hydrocodone. He practiced internal medicine, maintained medical offices in Palmdale, Rosamond, and Ridgecrest and surrendered his medical license last year. From February 2011 until May 2016, Kumar defrauded the Medicare health care benefit program by prescribing unnecessary home health services in exchange for the payment of illegal kickbacks to him from a La Verne-based home health agency called Star Home Health Resources, Inc. Medicare paid $4,398,599 to Star based on the illegal kickback-tainted referrals from Kumar. Kumar caused false and fraudulent claims for reimbursement to be submitted to Medicare for Medicare beneficiaries that he did not personally examine or for patients he only briefly examined. Kumar also prescribed drugs that were not medically necessary and which were paid for by the Medicare Part D program.

            Kumar also admitted that between February 2013 and January 2016, he – without a legitimate medical purpose – prescribed 23,826 pills of the opioid drug hydrocodone (aka Vicodin or Norco) and 38,459 pills of the muscle-relaxer carisoprodol (aka Soma). 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 directed his office staff to sign his name on prescriptions for opioid drugs and also provided his staff with pre-signed prescriptions. Once, although Kumar examined a patient only once on the patient's very first visit, and afterwards caused prescriptions to be issued to the patient for hydrocodone and carisoprodol on a monthly basis for approximately a year and a half even though Kumar did not see the patient for any other physician examination.

            Kumar is the fifth and final defendant sentenced in this case. Elaine C. Lat, 50, of Fontana, was Star's chief operating officer and the case's lead defendant. She is serving a 30-month prison sentence in this matter after pleading guilty in May 2017 to one count of conspiracy and four counts of paying illegal kickbacks. Three other defendants, including Lat's parents, each pleaded guilty to criminal charges and were sentenced. 

About the Author

Fay Arfa

Fay Arfa has the distinction of being Certified as a Specialist in two separate areas of law – Criminal Law as well as Appellate Law – by the California State Bar, Board of Specialization. The National Board of Trial Advocacy has also awarded her a board Certification in Criminal Trial Advocacy. ...

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