Daphne Man Sentenced in Health Care Fraud Billing Case
|U.S. Attorney’s Office April 30, 2013|
Kenyen Brown, U.S. Attorney for the Southern District of Alabama, announces that defendant Nehal Bodalia, who pled guilty to health care fraud information in February, was sentenced to four years in prison, followed by three years of supervised release, and ordered to pay a $20,000 fine. From at least January 2010 through January 2013, Bodalia owned and operated the Rehab in Motion physical therapy practice, which had locations in Mobile and Robertsdale, Alabama. While operating his clinic, Bodalia devised and executed a scheme to defraud Blue Cross & Blue Shield (BC/BS) of Alabama by seeking reimbursement for medical procedures that had not been performed.
Bodalia’s scheme operated like this: physical therapists working at Rehab in Motion would input the procedures performed on a particular patient into an office computer program, which would generate billing tickets that were then sent to the patient’s insurance company. Bodalia directed the physical therapists to not close out the billing tickets after they entered the performed procedures. It was explained the reason the billing tickets should not be closed out by the therapists was so that Bill Jones of Affordable Billing in New Jersey, who supposedly handled billing for Rehab in Motion, could make any necessary changes to the tickets. However, Bill Jones does not exist, and Affordable Billing does not have a New Jersey office. Rather, after the therapists had entered the information into the computer system, Bodalia altered the billing tickets to make it appear as if certain medical procedures were performed, when, in fact, they had not been performed. Bodalia knew these fraudulently altered tickets would be submitted to an insurance company for reimbursement.
BC/BS Alabama confronted Bodalia with billing discrepancy, and he quickly paid back the insurance company. However, this was not Bodalia’s first experience with a health care fraud. In 2008, Bodalia was convicted of health care fraud in U.S. District Court for the Northern District of Georgia for a nearly identical billing fraud scheme.
This case was investigated by the Federal Bureau of Investigation in Mobile and Blue Cross & Blue Shield of Alabama in Birmingham. The case was prosecuted by the U.S. Attorney’s Office for the Southern District of Alabama.