Ashikkumar A. Raval, Manish A. Raval, Medicare Billing Scam, New York 2024

For submitting false claims to Medicare and Medicaid, a Newburgh medical practice and its owners have agreed to pay $600,000 in fines and penalties.

ORANGE MEDICAL CARE, P.C. and its owners, ASHIKKUMAR A. RAVAL and MANISH A. RAVAL, have admitted to submitting claims for primary care services that were not rendered or supervised by the physician identified in the claim for payment and had, in fact, been rendered by non-credentialed providers.

The RAVALS are physicians who own and operate ORANGE MEDICAL, a family medicine practice that provides primary care services to patients in Newburgh, New York. The settlement resolves claims that ORANGE MEDICAL and the RAVALS fraudulently billed Medicare and Medicaid by submitting claims for primary care services that were not rendered or supervised by the physician identified in the claim for payment.

Under the settlement approved Saturday, August 17, 2024, by U.S. District Judge Paul Gardephe, ORANGE MEDICAL and the RAVALS will pay $268,800 to the U.S. and have admitted and accepted responsibility for conduct alleged in the Complaint as further described below. ORANGE MEDICAL and the RAVALS have also agreed to pay $331,200 to the State of New York to resolve the State of New York’s claims, for a total recovery of $600,000.

U.S. Attorney Damian Williams said: “Orange Medical and the Ravals submitted false claims to Medicare and Medicaid, failing to accurately identify who was involved in their patients’ treatment. This Office is committed to ensuring that individuals and entities billing federal health care programs do so in an honest manner.”

HHS-OIG Special Agent in Charge Naomi Gruchacz said: “As a part of this settlement, the defendants acknowledged that Orange Medical obtained funds from the Medicare and Medicaid programs for claims that did not comply with those programs’ billing rules. Individuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients.”

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