Indian American doc jailed for massive health-care fraud

Chicago-based cardiologist Dr Sushil Sheth, who surrendered his medical license, was sentenced to five years in federal prison for stealing about $13 million from Medicare and more than 30 other public and private health-care insurance programs over five years.

Sheth, 50, who had privileges at three unnamed area hospitals, lied thousands of times to Medicare and other insurers for patients he never treated, the prosecution charged.

He used the proceeds to live a lavish lifestyle, purchasing a suburban mansion, property in Arizona, luxury automobiles, and investing in venture capital opportunities, the charge sheet noted.

United States District Judge Rebecca Pallmeyer ordered him to begin serving the 60-month prison term in two months. He pleaded guilty a year ago to one count of health-care fraud.

He was also ordered to pay restitution totaling approximately $13 million and agreed to forfeit property and funds totaling more than $11.3 million the government seized from him.

He admitted that he obtained approximately $13 million between January 2002 and July 2007, including approximately $8.3 million from Medicare and some $5 million from other public and private health-care insurers in fraudulent reimbursement for services not performed.

Sheth used his hospital privileges to access and obtain information about patients without their knowledge or consent. He then hired individuals to bill Medicare and other insurance providers for medical services he purportedly rendered to patients whom he never treated.

Typically waiting almost a year after the treatment was purportedly provided, Sheth submitted more than 14,800 false claims for reimbursement for providing cardiac care requiring hands-on treatment in an intensive care unit on multiple days during patients' hospital stays.

Sheth regularly submitted claims seeking payment that, when added together, had him providing more than 24 hours of medical services and treatment in a single day.

"Health-care fraud is one of the highest priorities of federal law enforcement," said Patrick J Fitzgerald, US attorney for the Northern District of Illinois.

"We will make every effort to recover any fraudulently obtained funds and to ensure dishonest physicians and other medical providers do not profit from cheating Medicare and private insurers."