Maryland Sukhveen K. Ajrawat indicted for federal health care fraud

Greenbelt, Maryland – A federal grand jury has indicted two doctors, Paramjit Singh Ajrawat, age 60, and his wife, Sukhveen Kaur Ajrawat, age 56, both of Potomac, Maryland, on charges of health care fraud in connection with the pain clinic they owned and operated. The indictment was returned on June 24, 2014.

The indictment was announced by United States Attorney for the District of Maryland Rod J. Rosenstein; Special Agent in Charge Robert Craig of the Defense Criminal Investigative Service – Mid-Atlantic Field Office; Special Agent in Charge Nicholas DiGiulio, Office of Investigations, Office of Inspector General of the Department of Health and Human Services; Special Agent in Charge Drew Grimm, Office of Personnel Management, Office of Inspector General; Special Agent in Charge Stephen E. Vogt of the Federal Bureau of Investigation; Special Agent in Charge Bill Jones, of the Washington Regional Office, U.S. Department of Labor – Office of Inspector General, Office of Labor Racketeering and Fraud Investigations; and Special Agent in Charge Paul Bowman of the U.S. Postal Service, Office of Inspector General.

According to the indictment, P. Ajrawat was a licensed physician in Maryland who specialized in interventional pain management. S. Ajrawat was a licensed psychiatrist in Maryland. The Ajrawats owned and operated Washington Pain Management Center (WPMC) located in Greenbelt.

The 16-count indictment alleges that from at least August 2008 through May 2014, the Ajrawats engaged in a scheme to defraud federal health benefit programs including: Medicare, Medicaid, TRICARE, Federal Employees Health Benefits Program and the Office of Workers’ Compensation Programs. Specifically, the indictment alleges that the Ajrawats filed claims for procedures that were not performed (rather, less expensive procedures were performed and then the Ajrawats falsely billed for procedures that provided higher reimbursements), or were not performed in compliance with the requirements for reimbursement.

For example the indictment alleges that the Ajrwats submitted claims that P. Ajrawat had performed an epidural, when instead P. Ajrawat had performed less invasive injections using lidocaine, which was not indicated for epidural use. The Ajrawats allegedly falsely documented the use of an ultrasound machine to direct needle placement in certain patient files and caused the alteration or destruction of patient files to conceal the scheme.

The indictment also seeks the forfeiture of $2,329,109, believed to be the proceeds of the scheme.

The defendants face a maximum sentence of 10 years in prison for each count of health care fraud. An initial appearance has not yet been scheduled.

An indictment is not a finding of guilt. An individual charged by indictment is presumed innocent unless and until proven guilty at some later criminal proceedings.

United States Attorney Rod J. Rosenstein praised DCIS, HHS-Office of Inspector General, OPM-Office of Inspector General, FBI, U.S. Department of Labor-Office of Inspector General, and the U.S. Postal Service-Office of Inspector General for their work in the investigation. Mr. Rosenstein thanked Assistant United States Attorney Kelly O. Hayes, who is prosecuting the case.

Source: “Doctors Indicted For Health Care Fraud,” news release of the United States Attorney’s Office, District of Maryland, June 26, 2014.

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Paula M. Morrissette fined; misrepresented self as psychologist

On or about April 11, 2013, the Massachusetts Board of Psychologists entered into a settlement agreement with Paula M. Morrissette, resolving allegations that she identified herself as a psychologist on a clinical supervision document submitted to the Board of Registration of Allied Mental Health Professionals by an individual applying for licensure. A review by the Board found that Morrissette had never been issued a valid psychologist license by Board. Under the terms of the agreement, Morrissette agreed to pay a $500 fine.

Psychologist Carol Orem-Hough surrenders license for double billing

On May 29, 2013, the Maine Board of Examiners of Psychologists issued a formal reprimand to psychologist Carole Orem-Hough. Orem-Hough agreed as well to surrender her license for at least one year. This action was the result of a complaint filed by a former patient of Orem-Hough, who reported that the psychologist disclosed that she was double billing the patient’s insurance and was double billing all of her patients who were insured by either Aetna or Harvard Pilgrim as they did not reimburse her what she felt she should be reimbursed.

State denies license to Donald D. Flemmer; misrepresented credentials to out-of-state employer

On August 17, 2012, the Maryland State Board of Professional Counselors and Therapists denied Donald Duane Flemmer’s (a.k.a. David Flemmer) application for licensure to practice as a licensed clinical professional counselor.

Flemmer, who was previously licensed in the state as clinical professional counselor, allowed his license to lapse on December 31, 2008 and failed to renew it.

The Board’s document states, among other things, that the Board received a complaint on December 2010 from the Maryland State Board of Examiners of Psychologists, alleging that Flemmer had submitted forged documents to the a prospective employer in which he misrepresented himself as a psychologist. The Board of Psychology also received a complaint from the prospective employer which alleged that Flemmer “fraudulently misrepresented himself as a licensed psychologist in the State of Maryland.”

In October 2010, Flemmer submitted an application for renewal of his clinical counseling license. The Counseling Board began a review of his application and, in doing so, received information from the Psychology Board about his alleged misrepresentation of his qualifications as a psychologist.

Under investigation by both the Counseling and Psychology Boards, Flemmer, among other things, denied applying for a position as a psychologist, “feigning confusion and surprise at such an assertion,” according to the Board’s document.

Flemmer had no explanation as to how the prospective employer had obtained forged psychology licensing documents with his name or why the prospective employer claimed that Flemmer had been hired as Director of Behavioral Health in its North Dakota facility.

The employer verified that Flemmer had been hired and had posed as a licensed psychologist for two weeks prior to the discovery of his forged credentials.

Counselor Mechell Toles sentenced to prison for fraud

A federal judge in Memphis has sentenced a state contract mental health counselor to three years in prison for fraud.

The Department of Justice announced 44-year-old Dr. Mechell D. Toles of Collierville was sentenced Tuesday on her guilty plea to one count of health care fraud.

U.S. Attorney Edward L. Stanton III said Toles billed the government for more than $600,000 worth of counseling that she did not perform. Stanton said Toles was contracted to help at-risk children, but said she “brazenly helped herself” to taxpayers’ money.

Toles received referrals from the Shelby County Juvenile Court. Hundreds of her referrals were minors covered by TennCare, which is funded with federal dollars.

A managed care organization noticed an unusually high number of counseling claims. The TBI investigated, leading to federal prosecution.

Source: “Collierville mental health contractor sentenced,” Kansas City Star, August 7, 2013.