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New Jersey Doctor Settles False Claims Act Allegations for $700,000
Ramsey-Based Medical Practice to Compensate for Alleged Healthcare Fraud
NEWARK, N.J. – In a significant healthcare fraud settlement, Dr. Arun Sehgal and his Ramsey-based medical practice, Preventive & Diagnostic Medical Center P.A., have agreed to a nearly $700,000 settlement to address allegations of violating the False Claims Act. U.S. Attorney Philip R. Sellinger announced that the settlement amounting to $693,490 plus interest aims to resolve accusations against the medical practice and its former medical director at the New Jersey Veterans Memorial Home in Paramus, Dr. Sehgal.
The allegations, spanning from January 1, 2017, to June 1, 2022, involve fraudulent billing practices including upcoding physician services, billing for more services than feasibly possible within a day, and charging for services not provided by Sehgal. Upcoding refers to the fraudulent practice of billing for a more expensive service than was performed, a tactic that was regularly employed by the defendants to inflate reimbursements from Medicare.
One of the most egregious claims includes billing for what has been termed "impossible days," where the volume of services Dr. Sehgal claimed to provide in a single day would require over 43 hours to complete, as was the case on March 2, 2018. Additionally, Sehgal was accused of billing for services to Medicaid beneficiaries on days he was not even present in the United States, further compounding the fraudulent activities.
The resolution of these allegations underscores the U.S. government's dedication to combating healthcare fraud, with the False Claims Act serving as a pivotal tool in these efforts. Assistant U.S. Attorney Robert L. Toll from the District of New Jersey’s Opioid Abuse Prevention and Enforcement Unit and Trial Attorney Daniel Meyler from the Department of Justice’s Civil Division Fraud Section, supported by HHS-OIG, represented the government in this case.
This settlement, while addressing claims of misconduct, does not constitute an admission of liability by Dr. Sehgal or his practice. It highlights the importance of vigilance and accountability in healthcare billing practices. The government encourages the reporting of potential fraud, waste, abuse, and mismanagement to the Department of Health and Human Services to ensure the integrity of healthcare programs and protect public funds.
