Wise Psychiatrist Sentenced For Federal Health Care Fraud
For Immediate Release
U.S. Attorney's Office, Western District of Virginia
ABINGDON, Va.- Uzma Ehtesham, a Wise, Virginia psychiatrist who defrauded Virginia Medicaid and Medicare by fraudulently billing these programs for services not performed, was sentenced yesterday to two years’ probation, six months of which must be spent on home detention, Acting United States Attorney Daniel P. Bubar and Virginia Attorney General Mark Herring announced today.
Ehtesham, 52, pleaded guilty in November 2020 to a one-count Information charging her with health care fraud.
“Eradicating health care fraud remains a top priority for this office,” said Acting U.S. Attorney Bubar today. “When people like Ehtesham’s steal from our state and federal programs, they divert funds from the most vulnerable in our communities. We will continue to work closely with the local, state, and federal law enforcement partners whose good work brought Ehtesham to justice.”
“Health care providers and other individuals who defraud our health care system just to line their own pockets are not only stealing from Medicaid and Medicare, but they are also stealing from taxpayers and they must be held accountable,” said Attorney General Herring. “I want to thank our state and federal partners for their cooperation on this case, as well as my Medicaid Fraud Control Unit for their hard work and dedication.”
According to court documents, from 2010 to 2016, Ehtesham devised a scheme to defraud Virginia Medicaid and Medicare by billing for individual office visits when she often saw patients in groups. Frequently, Ehtesham would meet with patients in groups of two to four in a single visit, but subsequently bill as if she had met with them independently.
In addition, Ehtesham billed for extensive, time consuming, and costly office visits when she was conducting brief office visits with a patient. In many instances, Ehtesham would only meet with a patient for five to six minutes and then billed for services not supported by required documentation.
During the time of the investigation, Ehtesham was seeing more than 50 patients per day. Prescriptions were often written in advance of a scheduled visit by the office staff, placed in patient files, and signed by Ehtesham during the brief patient visit. At times, Ehtesham did not employ any medically certified staff to compile a patient’s vital statistics – such as blood pressure, pulse, height and weight? -- at each visit. Instead, vital statistics were copied from previous patient visits to each new visit information sheet at Ehtesham’s direction.
As part of the scheme, Ehtesham received $500,000 in fraudulently obtained proceeds from Virginia Medicare and Medicaid.
As part of the plea agreement, Ehtesham is required to pay a total of $1,000,000 in restitution, fines, and forfeiture.
The investigation of the case was conducted by the Virginia Office of the Attorney General’s Medicaid Fraud Control Unit, Norton Police Department, Southwest Virginia Drug Task Force, and Virginia State Police. The following agencies assisted with the execution of a search warrant during the investigation: Big Stone Gap Police Department, Virginia Alcohol and Beverage Control Special Investigations Unit, Wise County Commonwealth’s Attorney’s Office, Wise County Sheriff’s Office, and Wise Police Department. Special Assistant United States Attorney Suzanne Kerney-Quillen, a Virginia Assistant Attorney General assigned to the Major Crimes and Emerging Threat Unit, is prosecuting the case for the United States. Virginia Assistant Attorney Generals and Special Assistant United States Attorneys Janine Myatt and Joe Hall also assisted with the investigation.
Updated April 18, 2023