TAMPA, Florida – U.S. District Judge James S. Moody Jr. sentenced 66-year-old Jayam Krishna Iyer of Clearwater, FL to six months in federal prison for committing health care fraud, ordered Iyer to forfeit over $52,000 in health care fraud proceeds, and order her to pay restitution to the Medicare and Medicaid programs, according to a press statement.
In addition, the court ordered Iyer to forfeit her Florida medical license, permanently excluding her from participating in the Medicare and Medicaid programs. And, Iyer agreed to surrender her DEA registration number, which had been used to prescribe controlled substances, and not to reapply for a DEA registration number for at least 20 years.
According to court documents, Iyer owned and operated Creative Medical Center, located on Druid Road East in Clearwater. The center functioned as a pain management clinic; Iyer conducted office visits and wrote prescriptions for controlled substances, including oxycodone, morphine, and fentanyl.
Beginning in July 2011 and continuing through December 2017, Iyer carried out a scheme to defraud Medicare by billing for face-to-face office visits with Medicare and Medicaid patients, when, in fact, certain patients had not gone to Iyer’s office and had not been examined by her on the claimed dates. Instead, family members of patients had visited Iyer’s office, where she issued prescriptions for Schedule II controlled substances, including oxycodone, to the family members in the patients’ names. Iyer thereby violated a Florida law requiring doctors to perform an in-person office visit and examination of each patient before issuing Schedule II controlled substance prescriptions.
Iyer also falsified her electronic medical records, including vital statistics, to make it appear that the actual patients had been present in her office for an office visit, when they had not.
Iyer submitted at least $52,000 in false and fraudulent Medicare and Medicaid claims.
This case was investigated by the Opioid Fraud and Abuse Detection Unit – one of 12 Department of Justice pilot programs created to help combat the opioid crisis that is ravaging families and communities across America. The unit focuses specifically on opioid-related health care fraud using data to identify and prosecute individuals that are contributing to the prescription opioid epidemic. The case was investigated by the Federal Bureau of Investigation, the Department of Health and Human Services Office of Inspector General, the Florida Office of Attorney General’s Medicaid Fraud Control Unit, and the Drug Enforcement Administration. It was prosecuted by Assistant United States Attorney Kelley Howard-Allen.