TRENTON – Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor (“OIFP”) announced today that a Hudson County doctor has been charged with health care claims fraud and other crimes in an undercover sting that allegedly caught him on video using an illegal “runner” to recruit patients to his medical practice and then billing an insurance company for treatments that were unnecessary or never performed on the patients.
Dr. Subramaniam Khanthan, 76, a pain management specialist who operates Hudson Medical, P.C. in Jersey City, has been charged with 16 counts of second-degree health care claims fraud and one count each of theft by deception and illegal use of runners (3rd degree.) The indictment was handed up by a state Grand Jury on Monday.
The charges stem from a joint undercover investigation by OIFP’s Medicaid Fraud Control Unit (‘MFCU”) and the Jersey City Police Department Special Investigations Unit that allegedly caught Khanthan on video engaging in a scheme to provide physical therapy treatments to patients who didn’t need them in order to fraudulently bill insurance providers for the services.
“We allege that Dr. Khanthan used his medical practice in a devious criminal enterprise that treated patients as instruments to satisfy his greed,” said Attorney General Grewal. “As our joint investigation with the Jersey City Police Department demonstrates, we will work hand in hand with law enforcement agencies around the state to identify and prosecute doctors who exploit their patients and bring shame to their profession by operating these bastions of corruption.”
According to prosecutors, two undercover officers from MFCU posed as patients being referred to Khanthan’s practice by an illegal runner. In 16 visits covertly recorded in audio and video form by the officers, Khanthan allegedly instructed the undercover officers to receive physical therapy when it was not necessary, as they had already stated they were not experiencing pain. Additionally, several of the covertly-recorded visits allegedly showed Khanthan making payments to the runner in exchange for patient referrals.
Khanthan then allegedly billed GEICO Insurance company (GEICO) for providing the unnecessary physical therapy, which included exercise, massage and electric stimulation. Khanthan also allegedly fraudulently billed GEICO for purported treatments he never performed on the undercover officers.
“It is especially galling when doctors are the ones running fraud schemes that undermine the integrity the insurance system and drive up costs for everyone” said Acting Insurance Fraud Prosecutor Christopher Iu. “We will vigorously protect patients and policy holders alike from unscrupulous physicians who think their medical degrees give them carte blanche to illegally manipulate New Jersey’s medical insurance industry for personal gain.”
The indictment is merely an accusation and the defendant is presumed innocent until proven guilty. Second-degree charges carry a sentence of five to 10 years in state prison and a fine of up to $150,000. Third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000.
Deputy Attorney General Fernando Maldonado of the Medicaid Fraud Control Unit presented the case to the grand jury. Detective Sandeep Singh coordinated the investigation under the supervision of Sergeant Kevin Weinkauff and Lieutenant Louis Renshaw.
Acting Insurance Fraud Prosecutor Iu noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting the Web site at www.njinsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.
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