On September 18, 2018, Clearwater doctor Jayam Krishna Iyer pleaded guilty to Medicare and Medicaid fraud. According to the plea agreement, Dr. Iyer used her NPI number and medical license to distribute narcotics, including oxycodone, to patients with whom she had no face-to-face examination, sometimes providing the medication to family members of the patients who brought a note with them.
The press release states :
Beginning at least as early as July 2011, and continuing through December 2017, Iyer executed and carried out a scheme to defraud Medicare by billing for face-to-face office visits with Medicare beneficiaries, when, in fact, certain patients did not go to Iyer’s office and were not examined by her on the claimed dates; instead, family members of the patients went to Iyer’s office with notes requesting that Iyer issue and provide prescriptions, including for Schedule II controlled substances like oxycodone, to the family members, and in the beneficiaries’ names—and Iyer issued those prescriptions. Iyer thereby violated a Florida law requiring doctors to perform an in-person office visit and examination of each patient before issuing Schedule II controlled substance prescriptions. Iyer also falsified her electronic medical records, including vital statistics, to make it appear that the actual patient was present in her office for an office visit, when the patient was not. Iyer submitted at least $51,500 in these types of false and fraudulent Medicare claims.
The DOJ Opioid Fraud and Abuse Detection Unit investigated this matter. The Middle District of Florida is one of twleve Districts around the country tasked with investigating and prosecuting criminal opioid medical professionals.