Former Los Angeles-Area Physician Sentenced to Two Years in Federal Prison for Defrauding Medicare and Illegally Prescribing Opioid Drugs
A former Los Angeles-area physician was sentenced today to 24 months in prison and three years of supervised release for engaging in a multi-faceted Medicare fraud scheme and for illegally prescribing thousands of opioid painkillers and muscle relaxers.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Nicola T. Hanna of the Central District of California, Assistant Director in Charge Paul D. Delacourt of the FBI’s Los Angeles Division, Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Los Angeles Regional Office and Special Agent in Charge William D. Bodner of DEA’s Los Angeles Field Division made the announcement.
Kain Kumar, 56, of Palmdale, California, was sentenced by U.S. District Judge Philip Gutierrez of the Central District of California, who also ordered Kumar to pay $509,365 in restitution, $494,900 in asset forfeiture, and a $72,000 fine. Kumar pleaded guilty on April 4, 2019, to one count of health care fraud and one count of distribution of hydrocodone.
As part of his guilty plea, Kumar admitted that from February 2011 until May 2016, he defrauded the Medicare health care benefit program by prescribing unnecessary home health services in exchange for the payment of illegal kickbacks to him from a La Verne, California-based home health agency called Star Home Health Resources Inc. Kumar further admitted that in furtherance of this scheme, he submitted false and fraudulent claims for reimbursement to Medicare for Medicare beneficiaries that he did not personally examine or for patients he only briefly examined. Kumar also admittedly prescribed drugs that were not medically necessary and which were paid for by the Medicare Part D program.
Kumar admitted that between February 2013 and January 2016, he prescribed 23,826 pills of the opioid drug hydrocodone (commonly sold under the brand names Vicodin or Norco) and 38,459 pills of the muscle-relaxer carisoprodol (sold under the brand name Soma) without a legitimate medical purpose. Kumar directed his office staff – who were not medical professionals – to issue prescriptions for these drugs to patients even though Kumar had not examined the patients, he admitted. Kumar instructed his office staff to issue prescriptions for opioid drugs by instructing his staff to sign Kumar’s name on prescriptions and by providing his staff with pre-signed prescriptions. In one instance, Kumar examined a patient only on the very first visit and thereafter on a monthly basis, for approximately a year-and-a-half, he caused prescriptions to be issued to the patient for hydrocodone and carisoprodol, even though Kumar did not actually see the patient for a subsequent physician examination.
Kumar was charged along with Errol Lat, 75, Thelma Lat, 74, Elaine Lat, 49, all of Rancho Cucamonga, California, and Corinne Chavez, 36, of Rosamond, California, in a second superseding indictment returned on July 2017. All co-defendants have pleaded guilty and have been sentenced.
This case was investigated by the FBI, HHS-OIG and the DEA. Trial Attorney Claire Yan of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Alexander F. Porter of the Central District of California prosecuted the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.