Nine convicted in health fraud scheme

By Pat Maurer

6-14-13 MUG Babubhai RathodA Mt. Pleasant Physician’s Assistant ‘s license was suspended June 5 by the Michigan Department of Licensing and Regulatory Affairs (LARA).

The suspension is based on the conviction of John Eric Roberts, P.A., of Mt. Pleasant last October 17 on charges of Conspiracy to Pay and Receive Health Care Kickbacks.

Roberts was one of three Mt. Pleasant PA’s and nine health officials across the State, named in a U.S. District Court – Western District of Michigan indictment on fraud charges last April in connection with a $950,000 health care kickback scheme involving referrals to medical clinics owned and operated by Babubhai Rathod in return for “bonus checks.”

Last November, Rathod, of Mount Pleasant, the owner and operator of medical clinics, outpatient rehabilitation facilities and home health care companies across Michigan, pleaded guilty to conspiracy to pay and receive health care kickbacks, a potential five-year felony. His sentencing was scheduled in February.

The government alleged that the kickback scheme funneled patients to clinics Rathod owned. He operated Lakeshore Spine & Pain P.C., based in Ludington with numerous offices in Michigan, and U.S. Rehab Services P.C., with offices around the state, including Grand Rapids, Howard City, Lansing and Mount Pleasant.

The Federal Bureau of Investigation and the U.S. Department of Health and Human Services’ Office of Inspector General began receiving reports about the fraud scheme in 2011, according to a article by John Agar last November.

Agar reported that “providers” received bonus checks from Rathod and others “linked to referrals of physical therapy, electromyography tests and home healthcare services,” entities owned by Rathod.

Agar continued that “For referring patients to Rathod’s businesses, physicians and mid-level practitioners received $50 for a patient covered by Medicaid, and $100 for a patient insured by Blue Cross Blue Shield of Michigan, Medicare, an auto insurer or worker’s.

Roberts and Clinton James Cornell, P.A., owner of Central Michigan Urgent Care and Cornell Health and Wellness in Mt. Pleasant, were indicted together in connection with the kickback scheme.

Roberts, who was affiliated with Cornell’s offices, performed contract services for Lakeshore Spine and Pain, and is also accused of referring patients to one or more of the companies affiliated with Rathod and others for illegal kickbacks, according to the indictment last year. Mt. Pleasant Physician Assistant Natalie Schutte was also named in the indictment.

Cornell reportedly was a former employee of Lakeshore Spine and Pain. The clinic was the site of a federal raid earlier.

In total nine professionals across the State were charged and convicted in connection with the scheme.

Earlier this year, Cornell pleaded guilty to recipient of a health care referral payment, a five-year felony, according to court records. Roberts pleaded guilty to conspiracy to pay and receive health-care kickbacks, also a five-year felony.

In February, Roberts was sentenced to four months in prison, followed by two years of supervised release, community service and mental health treatment and $70,000 in restitution.

The suspension of his license is mandatory with the conviction of a felony, a misdemeanor punishable by imprisonment for a maximum term of two years or a controlled substance-related conviction.

A Google Internet search revealed an earlier license suspension in 2008 and subsequent probation and reinstatement of Roberts’ Michigan license in 2010. The background check at said the earlier suspension was related to a conviction in April, 2008 when the PA was accused of Negligence/Incompetence, Lack of Good Moral Character, Criminal Conviction and Failure to Report/Comply as well as drug diversion. The license was fully reinstated in May, 2010.

On a website under his name, Roberts was also listed as a Physician’s Assistant at a Beaverton Health Clinic.

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