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South Bay QME, Venkat Aachi M.D. pleaded guilty to distributing hydrocodone outside the scope of his professional practice and without a legitimate medical need, and to health care fraud. The guilty plea was accepted by the Honorable Edward J. Davila, U.S. District Judge.

The DWC lists Vankat Aachi M.D. as a QME in Physical Medicine and Rehabilitation with offices at 221 E. Hacienda Avenue Suite D , Campbell, CA 95008-6625 and 2324 Montplelier Drive, Suite 2 , San Jose , Ca., 95116-1612

At the time of his arrest, federal prosecutors contended that Aachi submitted to an insurance company in July a false and fraudulent claim for payment for healthcare benefits, items and services.

According to the plea agreement, Aachi, 52, of Saratoga, was a licensed physician in the state of California who operated a pain clinic in San Jose. He maintained a DEA registration number authorizing him to prescribe controlled substances. Aachi admitted that from September 18, 2017, through July 2, 2018, he wrote hydrocodone-acetaminophen prescriptions that were outside the scope of his professional practice and not for a legitimate medical purpose.

The plea agreement describes transactions in which Aachi improperly distributed hydrocodone. For example, in November of 2017, he wrote a prescription enabling a patient to receive 90 hydrocodone-acetaminophen pills. Aachi did not conduct a physical examination of the patient nor discuss the patient’s pain or response to prior medication. Aachi acknowledged that he knew the prescriptions were not for a legitimate medical purpose and that he did not write the prescriptions in the usual course of his professional practice.

Further, Aachi admitted that on July 2, 2018, he falsely submitted to an insurance company a false and fraudulent claim for payment for healthcare benefits, items, and services. Aachi admitted he acted with the intend to defraud the insurance company.

On October 9, 2018, a federal grand jury indicted Aachi and charged him with six counts of distributing drugs outside the scope of professional practice, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C), and one count of health care fraud, in violation of 18 U.S.C. § 1347. Aachi pleaded guilty to one count under each statute.

Aachi remains free on bail pending sentencing. Judge Davila scheduled Aachi’s sentencing hearing for July 1, 2019.

Aachi faces a maximum sentence of 20 years in prison and a fine of $1,000,000 for the illegal distribution of hydrocodone count and 10 years in prison and a $250,000 fine for the health care fraud count.

Additional fines, restitution, and additional periods of supervised release also could be ordered at sentencing. However, any sentence following conviction would be imposed by the court after consideration of the U.S. Sentencing Guidelines and the federal statute governing the imposition of a sentence, 18 U.S.C. § 3553.

This prosecution is the result of investigations by the DEA, FBI, HHS-OIG, and the BMFEA. Through the BMFEA, the California Department of Justice regularly works with other law enforcement agencies to investigate and prosecute fraud perpetrated on the Medi Cal program against a wide variety of healthcare providers, including doctors and pharmaceutical companies.

This case was investigated and prosecuted by member agencies of the Organized Crime Drug Enforcement Task Force, a focused multi-agency, multi-jurisdictional task force investigating and prosecuting the most significant drug trafficking organizations throughout the United States by leveraging the combined expertise of federal, state, and local law enforcement agencies.