Third doctor convicted in massive Medicare fraud scheme

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A third Detroit-area doctor was convicted Monday for his participation in a $17 million Medicare fraud scheme involving medically unnecessary physician visits.

Following a jury trial, Gerald Daneshvar, M.D., 40, of West Bloomfield, Michigan, was convicted of one count of conspiracy to commit health care fraud, and was acquitted of two counts of health care fraud. Daneshvar worked for the Chicago-based home-visiting physician service, Lake MI Mobile Doctors, and had an office in Southfield, Michigan, from 2012 to 2013.

Evidence revealed that Daneshvar visited patients who did not qualify for visiting physician services, then billed the visits to Medicare using the most expensive billing codes.

Daneshvar billed Medicare for home visits requiring complex, 40- or 60- minute examinations, yet managed to log up to 22 home visits per day, averaging about 15 minutes or less with each patient, so he could bill for more visits. The doctor also ordered unnecessary tests so he would receive larger bonuses.

The other two physicians associated with this case are Leonard Van Gelder, M.D., 69, of Caledonia, Michigan, and Stephen Mason, M.D., 46, of Indianapolis, who each pleaded guilty to one count of conspiracy to commit health care fraud in March 2017 and December 2016, respectively. Both doctors admitted seeing patients who did not require their services and for whom bills were submitted to Medicare at the highest billing codes.

The scheme resulted in Medicare being billed approximately $17.1 million by Lake MI Mobile Doctors.

The case was brought as part of the Medicare Fraud Strike Force which operates in nine U.S. cities and has charged nearly 3,000 defendants who have collectively billed Medicare for more than $11 billion.

H/T: Justice.gov

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