On September 29, 2010, the U.S. Department of Justice announced that it had reached an agreement with former cardiologist Sushil Sheth in which he will pay $20 million to settle a lawsuit brought under the False Claims Act alleging that he submitted thousands of false claims for payment to Medicare and other government healthcare programs. Sheth had previously pleaded guilty to healthcare fraud in a separate criminal case and was sentenced to 5 years imprisonment and ordered to pay restitution totaling $13 million and to forfeit property and funds totaling $11.3 million. Sheth admitted to abusing his hospital privileges to acquire information about patients without their knowledge and consent. He then employed individuals to bill Medicare and other healthcare programs for medical services to patients that he never actually provided. Sheth submitted nearly 15,000 claims for reimbursement for the highest levels of cardiac care. Indeed, he regularly submitted claims that, when added together, would amount to him providing over 24 hours of medical services and treatment in a single day. According to authorities, Sheth used the proceeds from his fraudulent activity to fund his lavish lifestyle, which included purchasing a suburban mansion, luxury automobiles, real estate in Arizona, and investing in a variety of venture capital opportunities.
The qui tam lawsuit was brought on behalf of the Government by whistleblower Dr. Lokesh Chandra, who had contracted Sheth to cover hospital rounds and patients while Chandra was unavailable. As a reward for disclosing Sheth’s fraud to the Government, Chandra will receive 17.5% of any amounts collected by the Government on the $20 million settlement.