Dr. Castro-Ramirez was convicted of one count of conspiracy to commit healthcare fraud, 11 counts of healthcare fraud and one count of conspiracy to launder the proceeds of the fraudulent scheme.
Beginning in 2003, the Detroit area physician entered into an agreement with Suresh Chand, a co-conspirator and owner of several companies based in Warren, Mich., that purportedly provided physical and occupational therapy services to Medicare beneficiaries, according to the release. In reality, Mr. Chand and his associates created false therapy files documenting physical and occupational therapy services to Medicare beneficiaries that had not occurred. The fictitious services were then billed to Medicare through fake providers controlled by Mr. Chand.
According to the release, Mr. Chand and others paid kickbacks and provided other inducements to Medicare beneficiaries in exchange for their Medicare numbers and signatures showing they had received therapy services. Dr. Castro-Ramirez signed therapy prescriptions falsely indicating that he had evaluated the Medicare beneficiaries and recommended the therapy, when in fact, he had not overseen any treatment to the patients and was aware that he was participating in fraud, according to the release.
Dr. Castro-Ramirez also wrote thousands of prescriptions for controlled substances including Vicodin and Xanax for patients he had never seen between 2003 and 2007, as part of Mr. Chand’s recruitment of the Medicare beneficiaries, according to the release.
Dr. Castro-Ramirez profited from the scheme by receiving proceeds from billings to Medicare for “home visits,” many of which were never made, for beneficiaries Mr. Chand recruited. Mr. Chand also distributed proceeds directly to Dr. Castro-Ramirez through transactions intended to hide the origins and nature of the funds, according to the release. Dr. Castsro-Ramirez submitted $1.4 million in claims to Medicare for the “home visits,” $929,000 of which Medicare paid. Mr. Chand and his co-conspirators submitted claims to Medicare totaling $18.3 million for therapy services that were supposedly overseen by Dr. Castro-Ramirez but were never performed. Of these, Medicare paid $8.56 million.
Mr. Chand pleaded guilty in Sept. 2009 in U.S. District Court to one count of conspiracy to commit healthcare fraud and one count of conspiracy to launder money.
At a scheduled June sentencing, Dr. Castro-Ramirez faces a maximum penalty of 10 years in prison and a $250,000 fine for the healthcare fraud conspiracy and fraud counts, as well as a maximum penalty of 20 years in prison and a $250,000 fine on the money laundering conspiracy count.
Read the Justice Department’s release on Dr. Castro-Ramirez.
