A Chicago doctor was recently charged in a kick back case. Medicare and Medicaid patients can be valuable to individuals looking to make money from sending referrals to doctors and hospitals in exchange for kickbacks. There are several layers of the health care industry from patient consultants and group service providers to the doctors and administration at small and large patient care facilities. The separation among health care service industry workers should prevent wrongdoing. In this recent case, a doctor directly offered a number of valuable patients in exchange for a cash kickback from the provider.
A doctor from suburban Lemont, Illinois, was charged with illegal remunerations.
Dr. Neil Sharma, 34, worked as the medical director of an Illinois healthcare company that worked as a managed care organization in the Illinois Integrated Care Program. The company has contracts with Medicare and Medicaid and made patient referrals to doctors and service providers for patients enrolled with the company. The doctors and service providers bill the Medicaid beneficiaries when they treat the referred patients, many of whom are elderly and require ongoing care and services.
According to the complaint, as reported in recent news[i], Dr. Sharma is accused of receiving a $2,500 cash kickback from an individual provider in exchange for guaranteed patient referrals. The plan had been cash payments every month for the referrals.
If found guilty of the charge of illegal remunerations, Dr. Sharma could receive a sentence of up to five years in prison and face fines up to $25,000.
The Illinois Department of Financial and Professional Responsibility investigates cases that can lead to discipline.
The Illinois Department of Financial and Professional Responsibility (“IDFPR”) maintains a website where the public can look up the status of a professional’s license to practice in Illinois. Dr. Sharma is listed on the site as of the date of this article as having an active license and board certified in the area of geriatric patient care and family medicine.
When the IDFPR receives notice of an alleged violation of law, often directly from the charging authority, an investigation may take place to review the allegations and result of the legal process before making a recommendation. The Department can take no action, censure a professional or seek suspension or revocation through administrative prosecution.
What evidence occurs in the underlying case might have different weight with the IDFPR despite the treatment of that evidence in a civil or criminal court. For example, a small infraction of law with minor outcome, such as payment of forfeiture, can lead to greater concerns for the professional’s license and ability to earn a living in the event there is a history of inquiries and discipline. A professional licensing attorney can help advise and represent professionals facing licensing inquiries and charges.
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