Texas MD Faces Significant Prison Time for TRICARE Fraud

A Texas physician faces significant time behind bars after being convicted of engaging in a scheme to fraudulently bill TRICARE, for toxicology and genetic tests that were not provided as represented and/or were medically unnecessary. TRICARE is the healthcare program for uniformed service members, retirees, and their families, 

Dr. Sekhar Rao, a vascular and interventional radiology specialist and medical director at ADAR Group LLC., authorized toxicology and genetic testing, including cancer genetic testing, for TRICARE beneficiaries without seeing, speaking to, or otherwise treating patients, and without incorporating the test results into ongoing treatment, according to court documents and evidence presented at trial.

In some cases, the patients did not know what they were being tested for. TRICARE beneficiaries were enticed to provide urine or saliva specimens in exchange for $50 gift cards. Evidence at trial demonstrated that Rao was paid in exchange for signing off on medically unnecessary and repetitive toxicology and genetic tests. In many instances the patients never even saw their test results.

The fraud is alleged to have taken place between May 2014 and June 2016, Rao, along with Dr. Vinay Kumar Parameswara and others, caused the submission of more than $36 million in false and fraudulent claims to TRICARE. 

Rao was convicted of two counts of healthcare fraud and is scheduled to be sentenced in March 2023. He faces up to 10 years in prison for each healthcare fraud count. He was one of 35 defendants charged in September 2019 as part of Operations Double Helix in which dozens of telemedicine companies and cancer genetic testing laboratories (CGx) allegedly participated in one of the largest healthcare fraud schemes ever charged totaling $2.1 billion.

As early as 2016, we were writing about how genetic testing had become the latest scam targeting TRICARE. And in 2019, the U.S. Department of Health and Human Services Office of the Inspector General issued an alert relating to genetic testing fraud.

The Health Law Offices of Anthony C. Vitale can provide you with compliance oversight services, assuring that your business relationships are compliant with all federal and state fraud, waste and abuse laws. We also represent healthcare professionals in state and federal court who are charged with fraudulent billing, kickbacks, Medicare and Medicaid fraud and false claims, among others. Give us a call at 305-358-4500, or send an email to info@vitalehealthlaw.com and let’s discuss how we might be able to assist you.