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Indian-American doctor held for healthcare fraud

An Indian-American doctor has been arrested and indicted on charges of healthcare fraud and causing serious bodily injury to his patients.

india Updated: Jun 18, 2010 12:08 IST

An Indian-American doctor has been arrested and indicted on charges of healthcare fraud and causing serious bodily injury to his patients.

Kamal Tiwari, 58, a medical doctor practicing in Bloomington, Indianapolis, was arrested on Thursday and was scheduled to appear before a US Magistrate Judge in Indianapolis.

He has been indicted by a federal grand jury with health care fraud, fraud resulting in serious bodily injury and 11 counts of unlawful drug distribution.

Tiwari also defrauded healthcare benefit programmes, including Medicare and Indiana Medicaid.

The indictment alleges that from 2002 through 2007, Tiwari was paid approximately $ 21,617,687 by these healthcare benefit programmes alone.

According to the indictment, Tiwari allegedly asked patients to undergo medically unnecessary injection procedures, such as trigger point injections and radiofrequency ablations, as a condition of receiving narcotic controlled substance prescriptions.

The injection procedures were performed in a frequency and pattern that was not medically necessary, was outside the bounds of medical practice and not for a legitimate medical purpose, the indictment said.

"Tiwari prescribed controlled substances as part of a scheme to defraud, in such dosage frequencies, combinations of controlled substances to drug-dependent patients as were likely to cause and did cause those patients unwanted injection procedures," the indictment said.

The unnecessary medications resulted in patients becoming dependent on unwanted medical procedures, it added.

The indictment sets out 16 patients that specifically illustrate the medically unnecessary procedures and improper drug prescriptions.

The indictment also alleges 11 counts of illegal drug distribution and lists 11 prescriptions of controlled substances that were not for a legitimate medical purpose and beyond the bounds of medical practice.

"The allegations in this matter go well beyond the healthcare billing fraud we usually see. In this situation a physician not only used patients as pawns for profit, but actually compromised the health of some of Indiana's most vulnerable citizens," Indiana Attorney General Greg Zoeller said.

Zoeller said prescription drug abuse is made worse by physicians who abuse their position of trust by over-prescribing addictive painkillers to patients who may well be addicts.