Press Release
Contact:
RAYMOND E. BECKERING III
ASSISTANT U.S. ATTORNEY
PHONE: (616) 456-2404
DOCTOR SENTENCED FOR HEALTH CARE FRAUD
WEDNESDAY, FEBRUARY 4, 2009 - MARQUETTE, MICHIGAN ––Dr. Gope Hotchandani, 61 years old, was sentenced to 30 days in jail and 5 months of home detention for felony health care fraud, U.S. Attorney Donald A. Davis announced today. At a hearing in Marquette, Michigan, U.S. District Judge Robert Holmes Bell found that Dr. Hotchandani, a licensed and board certified surgeon, defrauded Blue Cross and Blue Shield of Michigan a total of $18,656.14 related to the up-coding of office visits for acne treatment.
Dr. Hotchandani, who operates the Hotchandani Laser and Vein Centers in Marquette and Iron Mountain, Michigan as well as in Appleton and Green Bay, Wisconsin, had previously pled guilty to a single count of federal felony health care fraud, admitting that he billed Blue Cross Blue Shield of Michigan for the highest level office visit for an acne treatment, in order to obtain maximum insurance reimbursement, when the actual office visit involved only minimal patient evaluation. Judge Bell also imposed other sanctions, including a $20,000.00 criminal fine and three years of supervised release.
Noting that this fraud occurred after Blue Cross and Blue Shield had performed an audit visit and found that the doctor’s office improperly submitting a separate cosmetic procedure for reimbursement, Judge Bell also ordered that Dr. Hotchandani hire a medical reimbursement consultant who must review any future billing compliance and file regular compliance reports with the U.S. Probation Office. The judge additionally ordered that any future advertising done by Dr. Hotchandani must include the following statement to prospective clients: “Insurance Reimbursement Only for Medically Necessary Procedures.” As a result of the conviction for a federal health care fraud felony, Dr. Hotchandani will also be automatically excluded from participating with Medicare and Blue Cross and Blue Shield for a least five years.
U.S. Attorney Davis emphasized that: “Protecting the integrity of Medicare and our private health care insurance system is of paramount importance to the United States Attorney’s Office. Today’s sentence is another warning to health professionals who abuse the trust that our health care system must place on their accurate description of the diagnosis of patients and descriptions of procedures. Medical professionals who abuse this trust will suffer consequences that include incarceration, fines, and loss of the ability to participate with insurance providers in the future.”
Gregory W. Anderson, Vice President of the Corporate and Financial Investigations Department of Blue Cross and Blue Shield of Michigan, extended his thanks to the U.S. Attorney’s Office and the FBI for prosecuting Dr. Hotchandani. Anderson urged anyone with a concern about health care claims for service or health care providers to contact the BCBSM toll-free anti-fraud hotline at 1-800-482-3787.
The investigation team was lead by FBI Special Agent Paul Cowley, and the prosecution was lead by Assistant U.S. Attorney Ray Beckering
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