Recently, we posted an investigation by the Center for Public Integrity that found that fraudulent billing practices by hospitals and physicians appears to be on the rise, wasting billions of taxpayer dollars that could be better spent. In an example of just such a case that hits close to home, a Bloomington, Indiana, doctor was sentenced by a federal judge to three years in prison and three years of probation, and ordered to pay $1.3 M in restitution for the charges of health care fraud and illegally prescribing drugs. The doctor, Kamal Tawari, was a specialist in anesthesiology and had a federal Drug Enforcement Administration license to prescribe controlled substances. The doctor plead guilty to the charges in March of 2012.
According to the U.S. Department of Justice, Dr. Tiwari’s practice operated from two Bloomington area facilities, “The Pain Management Center of Southern Indiana” and “The Pain Management and Surgery Center of Southern Indiana, Inc.” Dr. Tiwari’s patient were examined at the Pain Management Center and procedures were performed at the surgery center. Tiwari admitted to defrauding health care insurers, including Medicare and Medicaid, by performing and billing for procedures that were not medically necessary. Insurers typically require that health care services be “medically necessary” in order to get reimbursed. Additionally, the Department of Justice’s press release states that Dr. Tiwari prescribe controlled substances to drug-dependent patients in such a manner as to likely cause and did cause in many instances, those patents to submit to unwanted and unnecessary injection procedures and other services which caused his patients to become dependent on the medically unnecessary procedures. Dr. Tiwari stated he committed the fraud to increase revenues at his medical practice.
Healthcare billing fraud is a serious issue which drives up the cost of healthcare for everyone. However, in this instance, the fraud went well beyond billing fraud as Dr. Tiwari’s fraudulent acts for the purpose of boosting his own profits put his patient’s health at risk. He abused his position of trust and preyed on their vulnerability as potential addicts of prescription painkillers. The sentencing of Dr. Tiwari comes nearly two years after the initial indictment, and four years after the initial investigations. Dr. Tiwari has also been involved in several medical malpractice civil lawsuits over the course of his career.
For instances where a healthcare provider’s violation or abuse of their position has resulted in medical malpractice, our firm works to hold them accountable. Contact us by email or call our toll free number, 877-569-5377, for a free case consultation and to find out how we can help you.