Texas Man Sentenced in South Florida to Ten Years in Federal Prison for his Role in Tricare and Medicare Fraud Scheme
MIAMI – U.S. District Judge Cecilia M. Altonaga sentenced Senthil Kumar Ramamurthy, 38, of Texas, to 121 months in federal prison for his role in a scheme that defrauded Tricare and Medicare out of more than $9.6 million. Ramamurthy and his co-conspirators tricked beneficiaries into having the federal health care programs pay for medically unnecessary compounded prescription medicines and cancer genetic tests.
Ariana Fajardo Orshan, U.S. Attorney for the Southern District of Florida, Cynthia Bruce, Special Agent In Charge, Defense Criminal Investigative Service (DCIS), Southeast Field Office, and SAC Omar Pérez Aybar, Special Agent in Charge for Health and Human Services, Office of Inspector General (HHS-OIG) made the announcement.
Tricare is the health care program for the U.S. military that pays the health care costs of active and retired military personnel and their families, including the costs of medically necessary prescription medications. Medicare is a federally-funded program that provides free or below-cost health care benefits to certain individuals, primarily the blind, elderly, and disabled.
On November 12, 2019, Ramamurthy pled guilty to conspiring to commit health care fraud and conspiring to defraud the United States and receive health care kickbacks.
According to court records, Ramamurthy and his co-conspirators targeted Tricare for about 10 months, starting in 2014. After deceiving their way onto U.S. military bases, Ramamurthy and his co-conspirators convinced Tricare beneficiaries to sign-up for compounded prescription medications that the beneficiaries did not need. To encourage sign-up, Ramamurthy and his co-conspirators falsely told the beneficiaries that the pharmacies would custom-design their medications or that the medications were free. In fact, the medications were not custom-designed and the patients had co-payments. Compounding pharmacies paid Ramamurthy and his co-conspirators millions of dollars in kickbacks in exchange for sending the pharmacies expensive prescription orders.
In mid-2015, Tricare scaled back its reimbursements for compounded medications. Ramamurthy and his co-conspirators turned to Medicare. They paid doctors to refer Medicare beneficiaries to a lab in Georgia for cancer genetic screening testing, even though the doctors had never examined the beneficiaries. As with the compounded medications, the cancer genetic screening tests were not medically necessary. The owner of the Georgia lab, Minal Patel, 40, was indicted in the Southern District of Florida in September 2019.
“Ramamurthy used our military families, our elderly, and our disabled to bilk millions of dollars from our country’s vital health care programs. He is set to spend the next 10 years in federal prison paying for that,” said U.S. Attorney Fajardo Orshan. “I commit to you that along with its federal law enforcement partners, the U.S. Attorney’s Office will continue to fight health care fraud in South Florida.”
"Senthil Ramamurthy’s conduct was part of a multi-million dollar fraud scheme perpetrated on the military's healthcare program. Today's sentencing is a testament of the Defense Criminal Investigative Service's fierce commitment to protect America's Warfighters and the integrity of their healthcare program. DCIS will work tirelessly with our law enforcement partners and Federal prosecutors in order to bring to justice any unscrupulous individuals or organizations who decide to compromise and abuse the interests, health and well-being of our men and women in the military," said Cyndy Bruce, Special Agent in Charge of the Defense Criminal Investigative Service, Southeast Field Office.
“Ramamurthy preyed upon unsuspecting beneficiaries to enrich himself; however, his unlawful actions led not to riches, but a 10-year prison sentence,” said Omar Pérez Aybar, Special Agent in Charge, Office of Inspector General for the U.S. Department of Health and Human Services. “We will continue working with our law enforcement partners to protect government-funded health care programs and the beneficiaries served by them.”
Additional co-conspirators of Ramamurthy have pleaded guilty to federal criminal charges arising out of the fraud scheme: Asif Uddin, 32, of Missouri, Karl Voeller, 34 of Delray Beach, Florida, Jennifer John Carbon, 48, of Miami, Florida, John Scholtes, 56 of Boca Raton, Florida, Anthony Mauzy, 43, of California, Thomas Sahs, 41, of California, Rajesh Mahbubani, 46, of Texas, and Dr. Mangala Ramamurthy, 64, of Texas. They are scheduled for sentencing in the Southern District of Florida in February 2020.
To date, fraudulent compounding pharmacy schemes have caused estimated losses to Tricare in excess of $2 billion. Fraudulent genetic testing lab schemes have caused estimated losses to Medicare of approximately $2.1 billion.
U.S. Attorney Fajardo-Orshan commended the investigative efforts of DCIS and HHS-OIG. Assistant United States Attorneys Kevin J. Larsen, Ana Maria Martinez, and John C. Shipley prosecuted the case. Assistant United States Attorney Daren Grove is handling the asset forfeiture aspects of the case.