Assistant U.S. Attorney Craig R. Gestring, who is handling
the case, stated that Dr. Cheema is a licensed physician who provides
psychiatric services at his private practice, Upstate Psychiatry in Pittsford,
NY, as well as at Rochester Regional Health, and various nursing homes. In
addition to his private practice, Dr. Cheema was paid over $855,000 by multiple
pharmaceutical companies for 341 promotional speaking engagements and 62
consulting opportunities between August 2013 and December 2016.
According to the complaint, the FBI began an investigation
after learning from Excellus BlueCross BlueShield that the defendant routinely
and systematically changed office visit billing codes, billed insurance
companies for telephone appointments as office visits, and regularly had 30 or
more patients on his daily schedule despite the fact that his daily private
practice office hours were 11:00 a.m. to 5:00 p.m. A 2015 audit conducted by
Excellus on eight patients during a six month time period revealed an
overpayment of 54% to the defendant for services not rendered and upcoding of
office visits. Dr. Cheema routinely billed the highest leve1 of evaluation and
management services for new patient visits, and his medical notes were missing
the documentation to support the level of evaluation and management services
for his established patients.
Subsequent investigation by the FBI revealed that the
defendant routinely upcoded office visits of patients, improperly billed health
care benefit programs for services that he did not provided, and, on more than
one occasion, prescribed drugs to an undercover patient without performing an
physical exam or psychotherapy.
In addition, he defendant submitted a fraudulent certificate
which purported to show him to be board certified in Psychiatry. In fact, the
defendant was not board certified in Psychiatry, has never passed the ABPN
certifying examination in Psychiatry or Neurology. The FBI investigation
determined that the document submitted by the defendant was fraudulent, and was
generated on his desktop computer using a valid Certificate belonging a
psychiatrist in Arizona.
The defendant made an initial appearance this afternoon
before U.S. Magistrate Judge Marian W. Payson and was released on conditions.
Dr. Cheema is due back in court on September 25, 2018, at 9:30 a.m.
“These charges highlight our continued commitment to
ensuring that those who seek unjustly to enrich themselves by perpetrating
frauds against the health care system are brought to justice,” said U.S.
Attorney Kennedy.
“Investigations like the Cheema case highlight this crime
problem,” said Gary Loeffert, Special Agent-in-Charge of the FBI's Buffalo
Office. “We are committed to rooting out fraud in health care to protect
patients, their insurance companies, and the economy overall.”
New York State Financial Services Superintendent Maria T.
Vullo said, “As regulator of New York’s insurance industry, DFS commends the
Office of the U.S. Attorney for aggressively pursuing those who unlawfully
enrich themselves at the expense of hard-working taxpayers, and looks forward
to continuing our partnership to stamp out this kind of criminal activity.”
The complaint is the result of an investigation by the
Federal Bureau of Investigation, under the direction of Special Agent-in-Charge
Gary Loeffert, and the New York State Department of Financial Services, under
the direction of Superintendent Maria T. Vullo.
The fact that a defendant has been charged with a crime is
merely an accusation and the defendant is presumed innocent until and unless
proven guilty.
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