By: Richard L. Smith
A Ramsey, New Jersey, doctor and his practice have agreed to pay a substantial settlement of nearly $700,000.
NJ Attorney General Officials said Arun Sehgal, alongside his medical practice Preventive & Diagnostic Medical Center P.A., will pay $693,490 plus interest to resolve allegations of violating the False Claims Act.
The allegations against Sehgal, who previously served as the medical director at the New Jersey Veterans Memorial Home in Paramus, included a range of fraudulent activities spanning from January 1, 2017, to June 1, 2022.
Officials say these malpractices involved upcoding physician services, billing for an implausible number of services in a single day, and charging for services that were never provided.
Specifically, Sehgal and his practice were accused of regularly upcoding certain Current Procedural Terminology (CPT) codes, which resulted in claims for more complex and costly services than those actually performed.
Moreover, the practice was found billing for 'impossible days,' where the volume of services claimed was so high it was unrealistic for Sehgal to have performed them all.
For instance, on March 2, 2018, Sehgal billed for services exceeding 43 hours in a single day.
Additionally, there were instances where Sehgal billed for services to Medicaid beneficiaries in New Jersey on days he was not even in the United States.
Assistant U.S. Attorney Robert L. Toll of the U.S. Attorney’s Office, District of New Jersey’s Opioid Abuse Prevention and Enforcement Unit, and Trial Attorney Daniel Meyler of the Department of Justice’s Civil Division Fraud Section led the government's representation, with assistance from HHS-OIG.
This case underscores the government's commitment to combating healthcare fraud, leveraging the False Claims Act as a key tool.
The resolution of this case sends a strong message about the seriousness with which healthcare fraud is treated and the government's dedication to addressing it.
The public is encouraged to report any suspicions of fraud, waste, abuse, or mismanagement to the Department of Health and Human Services.