Rakesh Nathu, Medicare Fraud, Nevada 2009

Medicare Fraud

Rakesh Nathu, a Las Vegas physician, has agreed to pay $5.7 million plus interest to settle allegations that he submitted false claims to federal health care programs for various radiation oncology services, including intensity modulated radiation therapy, the Justice Department announced today. Intensity modulated radiation therapy is a sophisticated radiation treatment indicated for specific types of cancer where extreme precision is required to spare surrounding organs or healthy tissue.

The government alleges that Nathu submitted improper claims to Medicare, TRICARE and the Federal Employees Health Benefits Plan from 2007 through 2009 in which he double billed for several procedures affiliated with radiation treatment plans, billed for certain high reimbursement radiation oncology services when a different, less expensive service should have been billed and billed for medically unnecessary radiation oncology services.

“We expect that physicians who participate in federal health care programs will bill for their services accurately and honestly,” said Tony West, Assistant Attorney General for the Department’s Civil Division. “Double or excessive billing for procedures and services, as we’ve alleged here, won’t be tolerated by the Department or the taxpayers who pay for it.”

“Patients, employees, and others who suspect billing fraud on the part of doctors should not hesitate to report such fraud to federal authorities,” said U.S. Attorney for the District of Nevada Daniel G. Bogden. “Persons who file dishonest claims with the government in order to enrich themselves will be investigated and aggressively pursued by the Department.”

Rakesh Nathu, Las Vegas physician, submitted false claims to federal health care programs for various radiation oncology services. Nathu agreed to pay $5.7 million plus interest to settle allegations.

This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of HHS in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the government has used to recover more than $5.7 billion since January 2009 in cases involving fraud against federal health care programs. The government’s total recoveries in False Claims Act cases since January 2009 are more than $7.3 billion.

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