Physicians who practiced at the Campbell Medical Group, Dr. Vilasini Ganesh a family practitioner and Dr. Gregory Belcher an orthopedic surgeon, were convicted of health care fraud by a federal jury after an eight-week jury trial.
The jury found Ganesh, 47, of Saratoga, guilty of five counts of health care fraud and five counts of making false statements relating to claims fraudulently submitted to health care benefit programs. Belcher, 56, also of Saratoga, was found guilty of one count of making a false statement relating to a health care benefit program. The defendants were acquitted of conspiracy and money laundering counts, and Belcher was also acquitted of four other health care fraud counts and one other count of making a false statement relating to a health care benefit program.
Evidence at trial showed that Ganesh submitted false and fraudulent claims to several health care benefit programs for services that she knew were not properly payable, by including claims for days when the patient had not been seen by the provider, and claims that the patients had been seen by another physician provider who was no longer affiliated with her practice.
Evidence at trial further demonstrated that Belcher had on at least one occasion submitted a false claim in connection with a billing matter related to his physical therapy practice.
On July 13, 2017, a federal grand jury indicted the defendants, charging them with one count of conspiracy to commit health care fraud, in violation of 18 U.S.C. § 1349; one count of conspiracy to commit money laundering, in violation of 18 U.S.C. § 1956(h); and multiple counts health care fraud, in violation of 18 U.S.C. § 1347, and 2 and false statement relating to health care matters, in violation of 18 U.S.C. § 1035.
The indictment alleged that Ganesh would misrepresent, conceal and hide her wrongdoings or direct her subordinates to do as such. When she was approached by representatives from the insurance companies or the patients themselves, for example, to provide documentation or additional information to substantiate the submitted claims, she’d either forbid her office staff from speaking to anyone about the claims or she would just resubmit the false information, according to the DOJ.
She was accused of working with Belcher to submit hundreds of claims for reimbursement from the insurance companies for days that were weekends when their practice was closed, days on which the patients denied they were seen and days when the patients could not have been seen by Ganesh or her staff because either the patient or the doctor was not physically present.
The doctors were suspected of using billing codes that indicated either one of them had spent more than 24 hours in a single day seeing patients. The pair allegedly maintained multiple bank accounts through which they tried to hide their illegally obtained money.
The defendants are currently out of custody, on a $350,000 bond as to Ganesh and a $250,000 bond as to Belcher. Judge Koh scheduled the defendants’ sentencing hearing for April 4, 2018.
Assistant U.S. Attorneys Patrick Delahunty and Jeff Nedrow are prosecuting the case with the assistance of Susan Kreider and Nina Burney Williams. The prosecution is the result of a two-year investigation by the Federal Bureau of Investigation.