A Lake Forest (Ill.) cardiologist pleaded guilty to one count each of mail, healthcare and tax fraud in U.S. District Court in Chicago and faces up to 18 years in prison, authorities said. Krishnaswami Sriram, M.D., 44, who operated a home-health company called Home Doctors, admitted to defrauding Medicare by filing false claims and to lying on his federal tax returns.
The U.S. attorney in Chicago charged that Sriram hospitalized patients who did not require hospitalization and performed unnecessary heart catheterizations and other cardiac tests as well. From 1996 to 2001, Sriram and Home Doctors falsely billed Medicare and Medicaid, prepared phony medical records and even submitted bills to insurers for as many as 32 patients who were dead at the time of the alleged treatments, prosecutors said.
According to the plea agreement, Sriram sometimes billed insurers for more than 25 hours in a single day, claimed that he treated the same patient in two different hospitals on the same date and allegedly saw as many as 187 patients in a single day. The cardiologist and Home Doctors billed for services that were not provided on dates when he wasn't in the U.S.
In supporting documents, federal prosecutors estimated Sriram defrauded insurers of more than $1.6 million. He faces $750,000 in fines and up to $2 million in forfeitures. A federal judge is scheduled to sentence Sriram Feb. 3. A spokesman for the U.S. attorney said the sentencing hearing could take up to a week because multiple patients and witnesses will be called to testify.
Assistant U.S. Attorney Jackie Stern, who is prosecuting the case, said Sriram and the government have not agreed yet on the extent of the doctor's crimes. "There are still legal and factual issues that need to be thrashed out," said Stern, who contended that Sriram put patients at risk. "Both sides are free to argue for what they deem appropriate."
While Sriram was not implicated in the massive federal criminal investigation of Chicago's now-closed Edgewater Medical Center, he performed many of the allegedly unnecessary cardiac catheterizations and other tests there. A doctor and university professor federal prosecutors hired to review those tests found that only three of 24 catheterizations Sriram performed and the doctor reviewed were medically necessary.
The scandal-plagued Edgewater, a 215-bed hospital accused of bilking insurers of more than $10 million in false billings and kickbacks, closed in December. Four doctors and a former Edgewater vice president have pleaded guilty to kickback and other health fraud charges, and the hospital's former management company, Merrillville, Ind.-based Bainbridge Management, faces a January criminal trial.