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Dr. Pankaj Merchia, 49, faces three counts of money laundering and one count of health care fraud stemming from the alleged schemes, the US Attorney's Office said.
The indictment lays out the two alleged frauds. In one, Merchia continued to bill patients' insurance companies for monthly rentals of CPAP and BiPap machines — breathing devices used to treat sleep disorders — for years after the patients had stopped using them and had returned them to his office, the Department of Justice said.
Federal prosecutors allege Merchia used the money he made from this scheme to purchase a $1.6 million home on Boylston Street in Brookline in 2019. Redfin lists it as a 6,200-square-foot, seven-bedroom, four-bathroom home "nestled on the slope of Fisher Hill" with views of Brookline Reservoir.
Dr. Merchia is also accused of billing the insurance company of a patient's family member more than $400,000 to rent a CPAP machine, even though he knew the company would not "pay for treatment rendered by a family member," the US Attorney's Office said.
Federal investigators said he used the money he made on this alleged scam to fund a $250,000 wire transfer and buy $140,000 in securities and stocks.
Merchia turned himself in to federal authorities earlier this week.
This is not the first time Merchia has had his billing practices questioned by regulators.
The Virginia Department of Health Professions said in a 2014 letter that Coventry Health Care accused Merchia of filing 550 claims worth $1.3 million in 2010 that the company denied after deeming them not medically necessary. Merchia did not provide any evidence to the contrary, the letter continued.
The Virginia regulators said he also overbilled Anthem Blue Cross & Blue Shield more than $76,000 between 2008 through 2011 and had not repaid that money in 2014. It's unclear if he ever repaid those funds.
The Virginia Board of Medicine reprimanded him in 2017 for sloppy handling of patient records. He blamed his father for the mistakes, records show.
Massachusetts records show Merchia graduated from Harvard Medical School in 1998 and completed his medical residency at Duke University Medical Center.
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