Houston, Texas, May 30, 2021: A Waxahachie nurse practitioner was sentenced recently to 20 years in federal prison and ordered to repay more than $52 million in restitution for his role in a health care fraud conspiracy, announced Acting U.S. Attorney for the Northern District of Texas Prerak Shah.
Trivikram Reddy, 39, 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 court 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 Mr. Reddy’s medical clinics.
On June 3, 2019, federal agents served a civil investigative demand at one 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. Mr. Reddy and his staff spent the next four months manufacturing fake medical records to turn over to authorities.
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