Fraud Watch: Doctor’s Conviction Overturned

New Orleans Doctor’s Fraud Conviction Overturned

A New Orleans-based doctor and owner of a home health care company will likely be released from federal prison after an appeals court overturned the original conviction.

Dr. Pamela Ganji and Elaine Davis were convicted of health care fraud and conspiracy to commit health care fraud in 2017. Ganji allegedly made “bogus referrals” for home health care services as a medical director for Christian Home Health Care, which was owned by Davis, The Advocate reported. The company received $28.2 million in Medicare payments between 2007 and 2015.

Ganji was sentenced to six years for her role in the scheme; Davis was sentenced to eight years in prison.

The appeals court that overturned the decision stated that the government’s case relied heavily on a number of witnesses that [who] never directly implicated Ganji and Davis.

Michigan Doctor Sentenced in $1.7 Million Fraud Scheme

A Detroit-based doctor was sentenced to 24 months in prison for his role in a $1.7 million fraud scheme in January.

Gerald Daneshvar, M.D., 41, of West Bloomfield, Michigan, and his co-conspirators worked for a home visiting physician company, Lake MI Mobile Doctors, which provided doctor visits to homebound Medicare patients. Daneshvar allegedly conspired with others to bill for the highest rates of Medicare services, even if visits were short, infrequent and perfunctory, or unnecessary.

He also referred these patients to home health services that were unnecessary and were then billed to Medicare. He was allegedly paid more by Mobile Doctors in exchange for referrals.

Mobile Doctors’ CEO pleaded guilty in a related case in the Northern District of Illinois and was was sentenced to 15 months in prison.

The case was investigated by the FBI and the Department of Health and Humans Services Office of Inspector General (HHS-OIG).

New York Home Health Company Settles Fraud Case for $6.4 Million

Home Family Care Inc. and its president, Alexander Kiselev, have agreed to pay $6.4 million to settle claims that they falsely billed Medicaid for services they did not provide.

[The] Former vice president of the home care company, Michael Gurevich, entered into a separate settlement resolving the same allegations, Reuters reported.

Written by Amy Baxter