U.S. District Judge James S. Moody Jr. sentenced Jayam Krishna Iyer, 66, to six months in federal prison for committing health care fraud, and ordered Iyer to forfeit more than $52,000 in health care fraud proceeds. He also ordered her to pay restitution to the Medicare and Medicaid programs.
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 Drug Enforcement Agency 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 the press release from the U.S. Attorney for Middle District of Florida, based on court documents, Iyer owned and operated Creative Medical Center, 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, prosecutors found.
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 was also found to have 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, the press release said.
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 authorities say is ravaging families and communities across America.