Michigan General Practitioner Sentenced to 14 Years in Prison for Involvement in Medicare Fraud, Submitting False Claims

A general practitioner from Farmington, Mich., has been sentenced to 14 years in prison and ordered to pay $9.4 million in restitution for his involvement in a scheme to defraud Medicare, according to a news release by the Department of Justice.

Jose Castro-Ramirez, MD, was convicted in March of conspiring with Suresh Chand and other co-conspirators to defraud the Medicare program. Mr. Chand, who was sentenced to 81 months in prison in April, owned and controlled several companies including a rehabilitation center in Warren, Mich. He paid cash kickbacks and other inducements to Medicare beneficiaries in exchange for Medicare numbers and signatures on documents falsely indicating they had received therapy services.

Mr. Chand then paid Dr. Castro-Ramirez in exchange for his signature on therapy prescriptions and other documents in falsified therapy files, which were later used to submit false claims to Medicare. In those files, he knowingly and falsely indicated that he had evaluated the recruited Medicare beneficiaries and certified the need for physical and occupational therapy services that were never rendered by Mr. Chand. Dr. Castro-Ramirez did not oversee any treatment provided to patients, according to the release.

In addition, Mr. Chand gave Dr. Castro-Ramirez a list of controlled substances or drugs the recruited Medicare beneficiaries preferred. Between Jan. 2003 and March 2007, Dr. Castro-Ramirez wrote thousands of prescriptions for the substances without ever seeing the patients.

Dr. Castro-Ramirez reportedly profited most in his involvement with the scheme by billing Medicare himself for home visits he purportedly made to Medicare beneficiaries Mr. Chand recruited. These home visits never occurred with the majority of the patients and therapy services were never discussed or ordered for the few patients he did see. Dr. Castro-Ramirez also profited from the scheme by accepting proceeds of the fraud from Mr. Chand.

Over the course of the scheme, Mr. Chand and his associates submitted approximately $18.3 million in false claims to the Medicare program for physical and occupational therapy services that were never rendered. Another $1.4 million in claims were submitted by Dr. Castro-Ramirez for his purported home visits.

Read the Department of Justice news release about Dr. Jose Castro-Ramirez' sentence.

Read other coverage on healthcare fraud in Michigan:

- Michigan Physical Therapist Sentenced to 57 Months in Prison for Medicare Fraud

- Detroit-Area Clinic Owner Sentenced to 81 Months for Role in Medicare Fraud

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