Brookline doc heading to jail following Medicaid fraud plea
A Brookline doctor was sentenced to jail time and ordered to pay more than $9 million in restitution after pleading guilty to running a Medicaid fraud scheme with sober houses, Attorney General Maura Healey said in a statement.
Preventive Medicine Associations, Inc., the company owned by Dr. Punyamurtula Kishore, 64, pleaded guilty Monday, April 6, in Suffolk Superior Court to eight counts of Medicaid kickbacks, 19 counts of Medicaid false claims and 11 counts of larceny over $250. Kishore personally pleaded guilty to one count of larceny over $250, Healey’s office said. Kishore and PMA were indicted on the charges in September 2011.
On Tuesday, April 7, Superior Court Judge Janet Sanders sentenced Kishore to 360 days in prison, with 11 months to serve and the rest suspended for 10 years. He also has to pay $9.3 million in restitution to MassHealth, which administers Medicaid in Massachusetts, and surrender his medical license.
“Dr. Kishore orchestrated a complex kickback scheme to funnel a lucrative drug screening business to his laboratories and then billed taxpayers millions of dollars for those services,” Healey said in a statement. “This case exhibited blatant theft of state funds that were supposed to go toward care for some of our most vulnerable residents. This is fraud that undermines the integrity of our health care system.”
Kishore was the owner and manager of PMA, with 29 medical branches throughout the state, including doctor office laboratories and one independent clinical lab. The investigation revealed that Kishore used kickbacks or bribes to get owners of sober houses to send residents’ urine drug screening business to his labs. Residents would typically be screened three times per week, according to the attorney general.
Drug screening tests may be billed to MassHealth if the test is deemed medically necessary, typically for between $100 and $200 per test. State regulations require that the medical provider must be “physically present and actively involved in the treatment of the member,” according to the attorney general’s office. The sober house residents whose urine was being tested had never been treated by PMA providers, according to the release.
Two sober house owners have previously pleaded guilty to one count each of Medicaid kickbacks in connection with their involvement with the scheme, Healey’s office said. Damion Smith, 42, of New Jersey, president of Fresh Start Recovery Coalition; and Carl Smith, 69, of Dorchester, manager of New Horizon House, each was sentenced to two years of probation in June 2012 and January 2015, respectively.
Carver resident John Coughlin, president of Gianna’s House Inc., which runs sober houses in Wareham, New Bedford and Sandwich, began his trial Tuesday, April 7, in Suffolk Superior Court. A case against Thomas Leonard of Malden, part owner and manager of the Marshall House in Malden, is ongoing.