Dr. Ghodrat Pirooz Sholevar, Medicaid Fraud, Pennsylvania 2024
Medicaid Fraud Scheme Uncovered in Philadelphia
A scheme to defraud the Medicaid program has been uncovered in Philadelphia, with a local doctor and his company agreeing to pay $900,000 to settle the allegations.
Dr. Ghodrat Pirooz Sholevar and his company, Nueva Vida Multicultural/Multilingual Behavioral Health, Inc., have been accused of submitting false bills to Medicaid for medication management appointments that were too short, violating rules promulgated by Community Behavioral Health, the local Medicaid program administrator, and the False Claims Act.
The government alleges that the visits, which were required to be at least 15 minutes in length to be fully reimbursable, were substantially shorter and that the defendants falsely recorded start and end times in patients' files to make it appear that the patients were seen for a full 15 minutes.
The defendants operated three mental health clinics in Northeast Philadelphia and provided psychiatry services under the Medicaid program to adults and children, including medication management appointments. The government contends that the defendants knew or recklessly disregarded the Medicaid rules regarding the timing of medication management visits.
Dr. Sholevar and his company have agreed to pay $900,000 to resolve the allegations, which date back to 2009. The defendants ceased operating mental health clinics in 2018.
“The defendants allegedly overbilled the Medicaid program at the expense of low-income Philadelphians, including children, who were seeking mental health services,” said U.S. Attorney Romero. “These individuals deserved full and appropriate health care services, including careful management of psychiatric drugs that can have dangerous side effects.”
Defendant Information
Defendant: Dr. Ghodrat Pirooz Sholevar and Nueva Vida Multicultural/Multilingual Behavioral Health, Inc.
Criminal Charges: Medicaid Fraud
City and State: Philadelphia, Pennsylvania
Exact Date: January 15, 2009 - March 31, 2017
Sentence or Outcome: Agreed to pay $900,000 to resolve allegations
Dollar Amounts: $900,000 settlement
Key Facts
- State: Pennsylvania
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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