On April 21, 2019, Sheetal Kanar Kumar, M.D. of Stuart, Florida, was sentenced to a total of 24 months in prison, to be followed by 2 years of supervised release. This sentence came after a trial in February where a federal jury convicted her of committing 23 acts of health care fraud. She was acquitted of 6 counts of health care fraud. Dr. Kumar testified on her own behalf at trial.
According to the court record, including evidence introduced at trial, Dr. Sheetal Kumar owned and operated the medical practice Advanced Healthcare for Women in Stuart, Florida. Dr. Kumar was an obstetrician and gynecologist who treated incontinence. Dr. Kumar testified at her trial and according to the press testified that she did not plan a fraud and if there were billing errors she should have been allowed to pay the amounts back before being indicted.
From January 2014 until July 2017, the government alleged that Dr. Kumar submitted or caused the fraudulent submissions of claims to Medicare, Medicaid and private insurance companies. The fraudulent claims sought money for specific health care benefits, items, and services that were not provided as billed. As a result of such false and fraudulent claims, Medicare, Medicaid and private insurance companies, made payments in the approximate amount of $637,000.
Attorney Commentary: The problem with a felony case is that it is not just the conviction but the collateral consequences that will follow a professional for the next 5 to 10 years, long after any sentence is served. Whether it is loss of a professional license, exclusion from Medicare and Medicaid programs, loss of a DEA license, loss of insurance contracts, the list of effects goes on and on. This is why anyone billing Medicare and Medicaid should have a compliance plan which will give a "safe harbor" and avoid the allegations of criminal fraud and keep the case in a civil and administrative place.
Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
Attorney Commentary: The problem with a felony case is that it is not just the conviction but the collateral consequences that will follow a professional for the next 5 to 10 years, long after any sentence is served. Whether it is loss of a professional license, exclusion from Medicare and Medicaid programs, loss of a DEA license, loss of insurance contracts, the list of effects goes on and on. This is why anyone billing Medicare and Medicaid should have a compliance plan which will give a "safe harbor" and avoid the allegations of criminal fraud and keep the case in a civil and administrative place.
Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
