WORCESTER, Mass., Jan. 11 -- The Massachusetts Attorney General issued the following news release:
A Dudley man and Holden doctor have been sentenced on charges they schemed to commit insurance fraud and submitted false health care claims while operating a medical facility, Attorney General Martha Coakley announced today.
Alan Perl, 67, of Dudley, pleaded guilty to charges of Insurance Fraud (19 counts), Larceny Over $250 (5 counts), Filing False Health Care Claim (3 counts), Larceny Under $250 Medicaid False Claims (21 counts), Larceny Over $250 by single scheme, Conspiracy and Unauthorized Practice of Medicine. After the plea was entered Judge James Lemire sentenced Perl to two years in the House of Correction, suspended for five years.
Lalit Savla, M.D., 75, of Holden, admitted to sufficient facts to the charges of Insurance Fraud (19 counts), Larceny Over $250 (5 counts), Filing False Health Care Claim (3 counts), Medicaid False Claims (21 counts), Larceny Over $250 by single scheme, Conspiracy and Larceny Under $250 and was sentenced to two years probation.
The defendants were ordered to pay more than $66,604 in restitution. As a condition of probation both defendants are forbidden to participate in, or provide any services payable by MassHealth and Medicare.
"These men fraudulently billed insurance companies and MassHealth for treatments that were administered by unlicensed and untrained individuals," AG Coakley said. "Fraud of this nature can lead to higher insurance premiums and possibly put patients at risk."
"Health insurance is a major cost in our economy, and we will work diligently with our partners in the law enforcement community to insure that health insurance fraud is minimized here in Massachusetts, and perpetrators are punished," said Daniel Johnston, Executive Director of the Insurance Fraud Bureau. "This anti-fraud effort is a major part of containing costs for health insurance."
The Attorney General's Office began an investigation into Perl and Savla's activities in March 2009, after a referral was made by the Federal Bureau of Investigation (FBI). On diverse dates between December 2006 and October 2008, Perl and Savla perpetrated a scheme in which they fraudulently billed insurance companies for treatment administered by unlicensed and untrained individuals at the Injuries Treatment Center (ITC), a Worcester-based physical medicine, rehabilitation and treatment facility owned and operated by Perl.
Perl, an unlicensed doctor since 1998, billed various insurance companies for his services as if he was a licensed physician and fraudulently billed companies for treatment administered by unlicensed individuals. Further investigation found that on relevant dates between December 2006 through February 2007, January 2008, and October 2008, Perl billed six different insurance companies and two health care plans through ITC fraudulently claiming that Savla treated 20 patients. During these three time periods Perl, who worked under the supervision of Savla, examined and administered treatment to patients despite his revoked medical license.
On dates between October 2006 and June 2009, Perl and Savla submitted claims to MassHealth under Savla's provider information for 21 MassHealth patients where Savla did not provide the services. The physical therapy and rehabilitation treatments billed to MassHealth were performed by one intern, two administrative assistants, Perl, and two other unlicensed healthcare providers.
Based on the total amount ITC billed insurance companies and MassHealth as a result of these schemes, Perl and Savla allegedly committed insurance fraud and Medicaid fraud in the amount of $80,574 and $13,843.96, respectively.
A Worcester County Grand Jury returned indictments against Perl and Savla on August 7, 2009 and on December 22, 2011. The defendants were arraigned in Worcester Superior Court on September 18, 2009 and on February 22, 2012 where they pleaded not guilty and were released on personal recognizance. Perl and Savla were sentenced January 4 and ordered to pay restitution.
This case was prosecuted by Assistant Attorneys General Margret Cooke and Stephen Adams of AG Coakley's Insurance and Unemployment Fraud Division and Evelyn Tang of AG Coakley's Medicaid Fraud Division, Investigator Dean Bates of the Medicaid Fraud Division, with assistance from investigators from the Attorney General's Office, FBI, Insurance Fraud Bureau of Massachusetts, and Health and Human Services Office of Inspector General. The Victim Witness Advocate was Ashley Cinelli of the Attorney General's Office.
TNS JF78JF-130112-4165770 EditorFurigay