Two executives of an Atlanta medical group have been arraigned on federal charges alleging they submitted more than 4,500 fraudulent claims for allergy treatments.
CEO Shailesh Kothari, who also goes by Shue Kothari, ran Primera Medical Group with COO Timothy McMenamin, who was also charged in the scheme, federal officials said in a press release. Kothari, 45, became licensed in January 2009 to practice as a doctor of chiropractic medicine in Georgia.
The health clinic allegedly drew patients’ blood so it could be sent to a lab for testing, but billed insurers for hundreds of tests that were not completed. When patients requested the lab test results, the defendants allegedly sent them false results.
McMenamin, 31, also allegedly created and sent false reports to insurance companies. The bills used the identification numbers of non-complicit doctors who hadn’t performed the services, the news release said.
FBI agents raided a Primera office on Peachtree Street in Buckhead to collect documents during its investigation last March. The defendants allegedly sought more than $8.5 million in insurance payments, U.S. Attorney Byung J. "BJay" Pak said in a statement.
“Healthcare fraud unfortunately diverts critical resources away from the patients that truly need care,” Pak said.
Kothari and McMenamin were arraigned this month on federal charges of conspiracy to commit healthcare fraud and aggravated identity theft. It will be the government’s burden to prove their guilt beyond a reasonable doubt at trial, the press release said.
Assistant U.S. Attorney Christopher J. Huber is prosecuting the case.
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Credit: Jason Getz / Jason.Getz@ajc.com