Physician sentenced for health fraud

A Bloomington physician is facing a federal prison sentence and was ordered to pay a restitution fee surpassing $1 million for health care fraud and unlawful drug distribution he admittedly committed in March.

Dr. Kamal Tiwari, 60, was convicted Tuesday, according to a press release by the United States Attorney’s Office.

District Court Judge Sarah Evans Barker sentenced Tiwari to 42 months in federal prison and ordered he pay a restitution fee of $1,299,866.54.

“Today’s sentencing holds accountable someone who betrayed both his profession and the trust of his patients, endangering lives and defrauding taxpayers of more than a million dollars,” U.S. Attorney Joseph Hogsett said in the release. “While we argued this morning in favor of sentence that we believe was befitting of the crimes committed, we respect Judge Barker’s decision and will continue to work with our law enforcement partners to make whole the victims of Mr. Tiwari’s actions.”

Tiwari’s practice specialized in interventional pain management. He admitted to officials he engaged in a scheme from January to December 2007 to defraud Medicaid, Medicare and Anthem by performing unnecessary medical procedures on patients, including injection procedures such as facet blocks, epidurals and radio frequency ablations, according to the release.

His practices exceeded the standard of care in interventional pain medicine practice, which can carry risks, among other side effects, of serious infection due to the excess steroids. Tiwari admitted to overprescribing the substances in order to increase revenue of his medical practice, according to the release.

He prescribed substances such as Percocet, Oxycontin, oxycodone and methadone. These substances exceeded legitimate medicinal purposes and caused several patients serious bodily injury.

“The epidemic problem of prescription drug abuse begins with overprescribing and ends by exacting a huge toll on our society,” said Indiana Attorney General Greg Zoeller, whose Medicaid Fraud Control Unit participated with federal authorities in the investigation of Tiwari, according to the release. “Actions against physicians who abuse their position of trust are part of the solution to this problem, along with public education and treatment of drug addiction.”

Dr. Tiwari practiced out of both the Pain Management Center of Southern Indiana and the Pain Management and Surgery Center of Southern Indiana. The businesses share an office suite.

He specialized in anesthesiology in Bloomington and was licensed by the Drug Enforcement Administration to prescribe controlled substances, according to the release.