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Philly Psychiatrist Billed Medicaid For Phantom Visits—Now Owes $900K: Feds

A Philadelphia psychiatrist and his mental health clinic must cough up $900,000 after allegedly billing Medicaid for thousands of bogus patient visits, federal authorities announced Monday, Jan. 27.

Dr. Ghodrat Pirooz Sholevar and Nueva Vida Multicultural/Multilingual Behavioral Health, Inc. allegedly orchestrated a years-long scheme, charging Medicaid for full 15-minute medication management appointments that often lasted mere minutes—or never happened at all—according to the U.S. Attorney’s Office for the Eastern District of Pennsylvania.

Sholevar and Nueva Vida ran three mental health clinics in Northeast Philadelphia, serving adults and children. Investigators say that from 2009 to 2017, Nueva Vida raked in cash for appointments that were impossibly short and even overlapped, with Sholevar allegedly seeing multiple patients at once or somehow being in two places at the same time.

“The defendants allegedly exploited the Medicaid program at the expense of low-income Philadelphians, including children, who sought critical mental health services,” U.S. Attorney Jacqueline C. Romero said. “These individuals deserved full and appropriate care, not rushed, fraudulent visits designed to maximize profits.”

Federal auditors flagged the fraudulent billing as early as 2004, but Sholevar and Nueva Vida allegedly ignored multiple warnings and continued the deception until the clinic finally shut down in 2018.

The Department of Health and Human Services Office of Inspector General investigated the case, with Assistant U.S. Attorneys Erin Lindgren and Gregory in den Berken leading the settlement.

The case, filed under the False Claims Act in the U.S. District Court for the Eastern District of Pennsylvania, underscores the government’s crackdown on healthcare fraud. Officials urged anyone with tips on Medicaid fraud to report it at 800-HHS-TIPS (800-447-8477).

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