September 26, 2014

Michigan Physician Pleads Guilty for Role in Medicare Fraud Scheme

WASHINGTON—A Detroit-area physician who made fraudulent referrals for home health care in a $1.3 million Medicare fraud scheme pleaded guilty today.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul Abbate of the FBI’s Detroit Field Office, and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) Chicago Regional Office made the announcement.

Dr. Vicha Janviriya, 77, of Southfield, Michigan, pleaded guilty before U.S. District Judge Arthur J. Tarnow in the Eastern District of Michigan to one count of conspiracy to commit health care fraud. Sentencing is scheduled for Jan. 21, 2015.

According to court documents, Janviriya admitted that from February 2006 through September 2012, he falsified medical documentation and falsely certified Medicare beneficiaries as homebound or requiring home health care services. In many cases, he had never met those beneficiaries. Janviriya admitted that he knew the false home health certifications would be used to support false claims to Medicare for services that were never rendered or not medically necessary, or where the Medicare beneficiary referrals were obtained through the payment of kickbacks.

Between February 2006 and September 2012, Janviriya caused Medicare to pay approximately $1,366,496 based on his false home health certifications.

This case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. This case is being prosecuted by Trial Attorneys Niall M. O’Donnell and Matthew Thuesen of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: