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Medicare's Most Wanted - Report Medicare Fraud: Indictment Charges Dr. Gautam Gupta and Dr. Rakesh Wahi with Defrauding Medicaid, Insurance Companies of $24 Million in Operation of Weight-Loss Clinics

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Tuesday, July 19, 2011

Indictment Charges Dr. Gautam Gupta and Dr. RakeshWahi with Defrauding Medicaid, Insurance Companiesof $24 Million in Operation of Weight-Loss Clinics

Source- http://www.fbi.gov/springfield/press-releases/2011/indictment-charges-two-doctors-with-defrauding-medicaid-insurance-companies-of-24-million-in-operation-of-weight-loss-clinics

SPRINGFIELD, IL—A federal grand jury has charged the owner of the Nutrition Clinics, based inRockford, Illinois, as well as an associate physician with defrauding government and private insurers, aswell as patients, of as much as $24 million from unwarranted medical tests and false billings for doctorvisits. Dr. Gautam Gupta, 56, of Rockford, and Dr. Rakesh Wahi, 57, of Mount Prospect, Illinois, wereboth charged in the indictment. At its peak, Nutrition Clinic operated at locations in Rockford, SouthBeloit, Naperville, Arlington Heights, and Chicago, and advertised extensively for patients usingtelevision and radio.

The court has ordered Wahi to appear before U.S. Magistrate Judge Byron G. Cudmore in Springfield onAug. 15. Gupta, previously charged in a criminal complaint filed on June 13, 2011, remains a fugitive.

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Self-described as a “weight-loss clinic,” according to the indictment, the Nutrition Clinic is owned by andoperated primarily by Gupta, who was most directly responsible for the treatment and billing of patientservices. Wahi became formally associated with the practice in September 2003, and as a medicaldoctor oversaw the medical processes, staff, and procedures at the locations to which he was assignedby Gupta.

The indictment alleges that from 2003 through at least January 2010, Gupta and Wahi, both licensed topractice medicine in Illinois, implemented and enforced policies and procedures at the clinics thatbenefitted them financially and resulted in submission of various fraudulent claims for payment. Theclaims were primarily for patients with certain insurance coverage, including those enrolled in Medicaidand Blue Cross Blue Shield of Illinois (BCBS), a private insurer. The alleged fraudulent claims includepayment for testing that was not medically necessary, including extensive blood screenings,echocardiograms, thyroid ultrasounds, and nuclear stress tests, and for follow-up visits billed as if adoctor examined the patient, when in fact, various unlicensed personnel actually saw and dispensedcontrolled substances given to patients for weight loss.

From 2003 through 2010, according to the indictment, Gupta and Wahi were paid approximately $2.28million by the State of Illinois and the U.S. government from the Medicaid program for claims submittedfor weight loss visits, tests and procedures. For the same time period, Gupta and Wahi were paidapproximately $22 million for similar claims submitted to BCBS.

The indictment alleges that on multiple occasions from 2003 to 2010, Gupta and Wahi examined patientswho came to the clinic seeking to lose weight. Under the doctor’s direction, a “medical assistant” woulddraw blood and administer a brief EKG. Gupta, Wahi, or another at their direction, allegedly performed acursory physical examination of the patient and regardless of the results of the EKG, if the patient hadinsurance, would order that the patient undergo an echocardiogram. Starting in late 2006, patients werealso ordered to undergo an ultrasound examination of the thyroid, even though doctors had not receivedor examined results of the patient’s blood tests. On multiple occasions, as alleged in the indictment, if apatient was covered by private insurance, primarily BCBS, they would also be referred for a thaliumstress test, typically conducted by Wahi. If a patient did not have insurance, no additional testing, otherthan a basic blood test, was ordered.

According to the indictment, Medicaid does not pay for tests used for screening as part of a weight lossprogram, and if tests are billed with no symptoms to justify the test, there is no reimbursement. Becauseof this requirement, Gupta and Wahi allegedly set and enforced practices and procedures resulting infalse diagnoses or symptoms reported to Medicaid to justify the various tests.

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Further, on multiple occasions, Gupta and Wahi allegedly required patients to return to the clinics for“follow-up visits” to continue to receive controlled substances and for weight loss “counseling.” Accordingto the indictment, Gupta established and Wahi oversaw policies and procedures that billed the follow-upvisits as if the patient had been examined by a doctor. In fact, patients rarely, if ever, saw a doctor orphysician assistant during the “follow-up” visits, and instead saw assistants who had little, if any,appropriate medical training, qualifications or licensing for counseling or to dispense controlledsubstances.

The indictment, which was returned late yesterday afternoon by the grand jury, charges both Gupta andWahi with one count of conspiracy to commit fraud and seven counts of mail fraud. Each is also chargedseparately with one count of health care fraud. If convicted, each count of mail fraud carries a maximumstatutory penalty of 20 years in prison and a $250,000 fine; the penalty for health care fraud is up to 10years in prison and a $250,000 fine. For conspiracy to commit fraud, the penalty is up to five years inprison. The court may also order that restitution be paid to those victimized by the crime.

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Don't Stop The Music -Rihanna

Beautiful Girls - SeanKingston



No One - Alicia Keys

Love Song - SaraBareilles

Young Forever - Jay Z FtMr. Hudson



Hate That I Love You -Rihanna Ft Ne-Yo

Say Something -Timbaland Ft Drake



Hey Daddy - Usher FtPlies

Run This Town - RihannaFt Jay Z & Kanye West

Right Round - Flo Rida



Kiss Me Thru The Phone -Soulja Boy Tell'em Ft

Sammie

Whatever You Like - T.I

Solo - Iyaz

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Day 'N' Nite - Kid Cudi

NOTICE AND PROCEDURE FOR MAKING CLAIMS OF COPYRIGHT INFRINGEMENT

Notification

The following information is provided exclusively for notifying the service provider that your copyrighted material may have been infringed. Written notification must be submitted to the following Service Provider & DesignatedAgent.

Name of Service Provider: W R N, L L C, Name of Agent Designated to Receive Notification of Claimed Infringement: MR. L. R. S W E E N E Y, Full Address of Designated Agent to Which Notification Should be Sent: 4012 S.Rainbow Blvd., #K-594, LAS VEGAS, NV 89103, Telephone Number of Designated Agent: ( 7 0 2 ) 5 3 0 - 7 0 7 6, Facsimile Number of Designated Agent: ( 7 0 2 ) 5 4 3 - 6 0 4 4, Email Address of Designated Agent:

[email protected].

To be effective, the Notification must include the following: 1. A physical or electronic signature of a person authorized to act on behalf of the owner of an exclusive right that is allegedly infringed; 2. Identification of thecopyrighted work claimed to have been infringed, or if multiple copyrighted works at a single online site are covered by a single notification, a representative list of such works at that site; 3. Identification of the material that is

claimed to be infringing or to be the subject of infringing activity and that is to be removed or access to which is to be disabled, and information reasonably sufficient to permit the service provider to locate the material; 4.Information reasonably sufficient to permit the service provider to contact the Complaining Party, such as an address, telephone number, and if available, an electronic mail address at which the complaining party may becontacted; 5. A statement that the Complaining Party has a good faith belief that use of the material in the manner complained of is not authorized by the copyright owner, its agent, or the law; and 6. A statement that the

information in the notification is accurate, and under penalty of perjury, that the Complaining Party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.

Upon receipt of the written Notification containing the information as outlined in 1 through 6 above: 1. Service Provider shall remove or disable access to the material that is alleged to be infringing; 2. Service Provider shallforward the written notification to such alleged infringer ("Subscriber"); 3. Service Provider shall take reasonable steps to promptly notify the Subscriber that it has removed or disabled access to the material.

Counter Notification

To be effective, a Counter Notification must be a written communication provided to the Service Provider's Designated Agent that includes substantially the following: 1. A physical or electronic signature of the Subscriber; 2.Identification of the material that has been removed or to which access has been disabled and the location at which the material appeared before it was removed or access to it was disabled; 3. A statement under penalty of

perjury that the Subscriber has a good faith belief that the material was removed or disabled as a result of mistake or misidentification of the material to be removed or disabled; 4. The Subscriber's name, address, and

mailto:[email protected]



telephone number, and a statement that the Subscriber consents to the jurisdiction of Federal District Court for the judicial district in which the address is located, or if the Subscriber's address is outside of the United States, forany judicial district in which the Service Provider may be found, and that the Subscriber will accept service of process from the person who provided notification or an agent of such person

Upon receipt of a Counter Notification containing the information as outlined in 1 through 4 above: 1. Service Provider shall promptly provide the Complaining Party with a copy of the Counter Notification; 2. Service Providershall inform the Complaining Party that it will replace the removed material or cease disabling access to it within ten (10) business days; 3. Service Provider shall replace the removed material or cease disabling access to the

material within ten (10) to fourteen (14) business days following receipt of the Counter Notification, provided Service Provider's Designated Agent has not received notice from the Complaining Party that an action has been filedseeking a court order to restrain Subscriber from engaging in infringing activity relating to the material on Service Provider's network or system.

Report Medicare Fraud at www.usawhistleblower.com

To report Medicare fraud please visit http://www.usawhistleblower.com/ or call the 24 hour toll free Medicare fraud hotline at 1-888-482-6825.

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WRN, LLC, medicaresmostwanted.blogspot.com is not affiliated with the FBI, the Department of Justice, Medicaid, Medicare, or theDepartment of Health and Human Services.

Contact Us: [email protected]

How to contact Medicare: To contact Medicare directly please call toll free call 1-800-447-8477 or visit Medicare's website at http://www.medicare.gov/

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Whistleblower Help Links - Report Medicare Fraud

Report Medicare Fraud at http://www.usawhistleblower.com/index.html

Medicare Fraud News & Whistleblower Help http://medicaresmostwanted.blogspot.com/

Medicare Fraud Hotline at http://medicarefraudhotline.com/

Healthcare and Pharma Employees Speak Their Minds at http://www.cafehealthcare.com/

Report Tax Fraud at http://www.irsrewards.com/

Tax Fraud News & Whistleblower Helphttp://irsmostwanted.blogspot.com/

Report Offshore Tax Fraud http://reportoffshoretaxfraud.com/

Internal Revenue Service http://www.irs.gov/

Medicare http://medicare.gov/

Medicare.gov - How to Report Medicare Fraud http://www.medicare.gov/fraudabuse/HowToReport.asp

Report Fraud to the Office of Inspector General http://www.stopmedicarefraud.gov/reportfraud.html

How to Report Suspected Medicare Fraud http://www.cms.hhs.gov/FraudAbuseforConsumers/

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blogspot.comMedicare's Most Wanted - Report Medicare Fraud: Indictment Charges Dr. Gautam Gupta and Dr. Rakesh Wahi with Defrauding Medicaid, Insurance Companies of $24 Million in Operation of Weight-Loss Clinics

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