Two doctors based in Saratoga have been accused in a scheme to defraud both patients and health insurers by charging for unperformed services, unseen patients, and over-exaggerating treatments, the U.S. Attorney’s Office stated.
Family practitioner Dr. Vilasini M. Ganesh, 46, and orthopedic surgeon Dr. Gregory Belcher, 54, both face one count of healthcare fraud conspiracy, one count conspiracy to commit money laundering, and six counts of money laundering. Ganesh also faces five counts of healthcare fraud and another five counts of making false statements relating to healthcare matters.
According to the authorities, both doctors made false claims through their practice, Campbell Medical Group. Their alleged abuses include charging providers for patients who were not even examined, exaggerating patient conditions and the amount of time spent with patients to bill more, and claiming that patients were attended to by doctors no longer associated with the practice.
The Mercury News reported that both were arrested Tuesday in Saratoga and were accused in federal court in San Jose. Both are free on $250,000 bond each, but are expected to return to court Friday.
The federal grand jury indictment, handed down May 19, indicated that Ganesh billed insurance providers for three separate days where her practice performed 116 hours, 114 hours, and 113 hours of patient care—more hours than humanely possible. Authorities also said that Ganesh submitted billing for days when the practice was closed, and also on occasions when neither staff nor patient were even present in California.
When providers and patients asked for documentation for the services they were billed for, authorities said that Ganesh instructed her staff to rebuff the inquiries or resubmit the false claims.
In one case highlighted by the indictment, the two doctors billed a patient $7,350 after an insurer refused to pay a purportedly inflated claim.
The indictment covers from July 2009 to September 2014, but authorities said that the period is simply a window in which the supposed crimes occurred.
Prosecutors asserted that the money both doctors defrauded from patients and insurers were deposited in a series of bank accounts—this fact became the basis of the money-laundering charges against the two.