New Jersey Pediatrician Settles Case Involving False Claims

On July 2, 2018, Rashmi Sandeep, MD (Dr. Sandeep), Brick, New Jersey, entered into a $336,298.52 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. Sandeep knowingly presented to Medicaid, through certain New Jersey Medicaid Managed Care Organizations (MCOs), claims for items or services that she knew or should have known were not provided as claimed and were false or fraudulent. Specifically, OIG alleged that Dr. Sandeep: (1) submitted or caused to be submitted claims for items or services provided to Medicaid beneficiaries, who were enrolled with certain MCOs, in which Dr. Sandeep failed to personally perform or directly supervise services billed under her NPI number because she was either not present in the United States or was otherwise not in the State of New Jersey; (2) caused the resubmission of previously denied claims for items or services provided to Medicaid beneficiaries enrolled with a particular MCO by identifying herself as the rendering provider when, in fact, she was not; and (3) submitted or caused to be submitted claims for items or services provided to Medicaid beneficiaries enrolled with a particular MCO under her NPI number for services performed by non-credentialed providers who were not supervised by Dr. Sandeep. Associate Counsel Srishti Sheffner represented OIG with the assistance of Paralegal Specialist Mariel Filtz.

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