A Chicago-area cardiologist was sentenced to five years in federal prison for stealing $13 million from Medicare and more than 30 other public and private healthcare insurance programs over the course of five years, federal law enforcement officials announced yesterday.
Dr. Sushil Sheth "lied thousands of times to Medicare and other insurers in order to receive millions of dollars he did not earn for patients he never treated," the Department of Justice press release said. He used his ill-gotten gains to support a lavish lifestyle, which included buying a suburban mansion, property in Arizona, luxury cars, and investing in venture capital projects.
Sheth pleaded guilty a year ago to one count of healthcare fraud after being charged in January 2009. Besides being ordered to pay restitution of $13 million, he agreed to forfeit property and funds totaling more than $11.3 million that the government seized from him.
Between January 2002 and July 2007, Sheth bilked $8.3 million from Medicare and some $5 million from other public and private healthcare insurers in fraudulent reimbursements for cardiac care. He used his hospital privileges at three Chicago-area hospitals to access patient info without their knowledge or consent, then hired people to bill Medicare and other insurance providers for medical services that he purportedly gave to patients whom he knowingly never treated.
Sheth typically would wait a year after the supposed treatment before submitting a claim for reimbursement. Apparently, though, he didn't care much about getting his "facts" straight, as he regularly submitted claims seeking payments based on his providing more than 24 hours of services and treatment in one day.
When FBI agents searched his home in June 2007, they seized more than 600 uncashed checks from various insurers totaling more than $6.7 million.
To learn more:
- here's the Department of Justice press release
- here's the Chicago Tribune article
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