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Hurdles

Medicare_2-696x522
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Most individuals have various identities, depending on their gender, religion, caste, ethnicity, or nationality. These identities are mostly inherited at birth. Then there are these identities that are acquired by the individual through education, political beliefs, and their professional and other accomplishments. And then…there are the fraudsters who just steal any identity that is conducive to some sort of scheme. Like Yogesh Pancholi. Assuming other identities for Pancholi was a way of life.

Yogesh Pancholi purchased a home health care company, Shring Home Care Inc, using the names, signatures, and personal identifying information of others to conceal his ownership of the company. Why did he do this? Because Pancholi was excluded from billing Medicare because he was a previously convicted Medicare fraudster. And Pancholi didn’t want that to get in the way of him stealing more money from the U.S. taxpayer. Just a small hurdle.

Upon fraudulently purchasing Shring Home Care, Pancholi billed millions of dollars to Medicare for services that were never provided. Pancholi then transferred these funds through bank accounts belonging to shell corporations and eventually into his accounts in India. The Centers for Medicare & Medicaid figured out that Shring Home Care really wasn’t delivering its services and Pancholi was indicted for healthcare fraud.

On the eve of his trial, Pancholi, doing what he used best, assumed another false identity. He falsely wrote to various federal government agencies alleging the government witness “in the case against Pancholi” had committed various crimes and should not be allowed to remain in the US to keep the witness from testifying. Luckily the judge knew a fraudster when he saw one. On September 27, 2023, Pancholi was convicted of health care fraud and now faces 20 years in prison.

Shout out to the FBI in this case.

Today’s Fraud of The Day is based on article “Indian national convicted for orchestrating USD 2.8 million healthcare fraud in US” published by The Times of India on September 28, 2023.
An Indian national has been convicted by a federal jury in Michigan for orchestrating a USD 2.8 million healthcare fraud and engaging in money laundering. According to court documents and evidence presented at trial, Yogesh Pancholi, 43, owned and operated Shring Home Care Inc, a home health company based in the US state of Michigan.

Despite being excluded from billing Medicare, Pancholi purchased Shring using the names, signatures, and personal identifying information of others to conceal his ownership of the company, a statement said.

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