Utica doctor indicted on health care, mail fraud charges
Fri, 16 Nov 2012 20:42:23 GMT —
A Utica doctor was indicted on charges of health care fraud and mail fraud.
A federal grand jury indicted 58-year-old Dilip Kachare on three counts of health care fraud and 16 counts of mail fraud.
Kachare has an outpatient and impatient practice in internal medicine. He also treats patients at St. Elizabeth Medical Center, Faxton St. Luke's Healthcare and several nursing homes in Utica.
Federal prosecutors say between 2002 and the end of September 2012, Kachare engaged in a scheme to fraudulently obtain payments from health care benefit programs, including Medicare, Medicaid, and numerous private insurers.
Here's how prosecutors say it happened:
"He did this by submitting claims for reimbursement representing that he had, on an ongoing and daily basis, provided a certain number of patients with the medical services designated by certain medical codes when, pursuant to the criteria in those codes, it would have been impossible for any physician to provide the medical treatment to that number of patients in a single day. The indictment also alleges that certain medical services, which are described in medical codes, known as CPT codes, have "typical" time components associated with them, and that during the course of the fraud scheme, the aggregate of the "typical" time in the codes submitted for reimbursement by Kachare consistently exceeded 24 hours per day. The three Health Care Fraud counts are designated "executions" of the fraud scheme described above, and each sets forth a time frame during which Kachare sought reimbursement for services purportedly provided to patients on November 29, 2007, February 20, 2008, and June 19, 2008. On those three dates, Kachare purports to have provided services to 82, 85, and 92 patients, and the aggregate "typical" time component associated with the codes submitted for payment were 30 hours, 35 hours, and 40 hours, respectively. The Mail Fraud counts allege the same fraud scheme as alleged in the Health Care Fraud counts, with each Mail Fraud count listing a check mailed to Kachare by the Medicare carrier containing payment for services purportedly provided on the three dates listed in the paragraph above, which services the indictment alleges were not, in fact, provided."
Kachare pleaded not guilty in federal court in Binghamton on Friday. He was released on his own recognizance, but was forced to surrender his passport.
Kachare faces a maximum sentence of 10 years in jail and a fine of up to $250,000 on the health care fraud charges. He faces a maximum sentence of 20 years in prison and a fine of up to $250,000 on the mail