Indian American Nurse Practitioner Sentenced to 20 years in Jail for Healthcare Fraud

Trivikram Reddy, 39, a Waxahachie, Texas nurse practitioner was sentenced On May 25, to 20 years in federal prison and ordered to repay more than $52 million in restitution for his role in a healthcare fraud conspiracy, announced Acting U.S. Attorney for the Northern District of Texas Prerak Shah.

Reddy, pleaded guilty to conspiracy to commit wire fraud in October 2020.  He was sentenced on Tuesday by U.S. District Judge Ada Brown.

According to department of Justice documents, Reddy, a licensed nurse practitioner, devised a scheme to defraud Medicare, Blue Cross Blue Shield of Texas, Aetna, UnitedHealthcare, Humana, and Cigna.

Reddy and his co-conspirators created false patient bills using the provider numbers of six doctors as the treating physicians on the claims.  All the claims were false and at no time did the six doctors provide billable services to any of Reddy’s medical clinics.

According to the DOJ press release, on June 3, 2019, federal agents served a civil investigative demand at o ne of Reddy’s medical clinics. When law enforcement arrived at the site, agents found Reddy’s staff manufacturing medical records.  Following the encounter, on June 8, Reddy closed the clinic and terminated his business entity with the Texas Secretary of State.

On June 13, 2019, Reddy made the first of multiple wire transfers which, in sum, totaled more than $55 million.  A forensic financial analysis directly tied the money to fraudulent health care claims submitted by Reddy.

Federal agents requested medical records to justify millions of dollars of paid Medicare claims paid between January 2014 and June 2019.  Reddy and his staff spent the next four months manufacturing fake medical records to turn over to authorities.

Reddy pleaded guilty to wire fraud in October 2020.

“When nurse practitioner Trivikram Reddy stole the identities of physicians to defraud Medicare and other insurers to enrich himself, he violated the basic trust that the public extends to healthcare professionals,” said Miranda Bennett of the HHS Office of Inspector General Dallas regional office in a DOJ press release.

“Today’s sentence sends a message to corrupt medical professionals that law enforcement will do everything possible to root out all forms of waste, fraud and abuse in our federal healthcare programs.”

Acting U.S. Attorney Shah, speaking on the matter said, “Mr. Reddy engaged in a scheme that defrauded Medicare and private insurance providers out of millions of dollars,” adding, “The Justice Department will continue to aggressively prosecute all types of health care fraud to protect the integrity of our health care system and ensure that criminals are held accountable.”

“Health care fraud affects everyone, it causes billions of dollars in losses each year and erodes trust in our health care system,” said Dallas FBI Special Agent in Charge Matthew DeSarno. “Mr. Reddy’s scheme defrauded multiple companies and put the professional reputation of six doctors in jeopardy all to line his own pockets. Along with our law enforcement partners, the FBI will continue to root out fraud in the health care industry and protect the public from illegal schemes.”

Reddy operated three medical clinics, Waxahachie Medical, Texas Care Clinics and Vcare Health Service.